Provider Demographics
NPI:1255174066
Name:HERITAGE DENTAL HEALTH, PC
Entity type:Organization
Organization Name:HERITAGE DENTAL HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ORIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-357-7707
Mailing Address - Street 1:116 MONADNOCK HWY
Mailing Address - Street 2:
Mailing Address - City:SWANZEY
Mailing Address - State:NH
Mailing Address - Zip Code:03446-2114
Mailing Address - Country:US
Mailing Address - Phone:603-357-7707
Mailing Address - Fax:
Practice Address - Street 1:116 MONADNOCK HWY
Practice Address - Street 2:
Practice Address - City:SWANZEY
Practice Address - State:NH
Practice Address - Zip Code:03446-2114
Practice Address - Country:US
Practice Address - Phone:603-357-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental