Provider Demographics
NPI:1265077093
Name:DAL SECO, PRISCILA P (DMD)
Entity type:Individual
Prefix:
First Name:PRISCILA
Middle Name:P
Last Name:DAL SECO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 COBURN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-2738
Mailing Address - Country:US
Mailing Address - Phone:603-459-9698
Mailing Address - Fax:
Practice Address - Street 1:2626 BROWN AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-6806
Practice Address - Country:US
Practice Address - Phone:603-625-1877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH045221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice