Provider Demographics
NPI:1457566283
Name:PATRICK M REDMOND DMD PA
Entity type:Organization
Organization Name:PATRICK M REDMOND DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-332-7050
Mailing Address - Street 1:121 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1303
Mailing Address - Country:US
Mailing Address - Phone:603-332-7050
Mailing Address - Fax:
Practice Address - Street 1:121 WAKEFIELD ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1303
Practice Address - Country:US
Practice Address - Phone:603-332-7050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1310122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty