Provider Demographics
NPI:1477683530
Name:NORTH CONWAY DENTAL ASSOC INC
Entity type:Organization
Organization Name:NORTH CONWAY DENTAL ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:BECHTOLD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:603-356-3355
Mailing Address - Street 1:PO BOX 896
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-0896
Mailing Address - Country:US
Mailing Address - Phone:603-356-3355
Mailing Address - Fax:
Practice Address - Street 1:125 PINE STREET
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-0896
Practice Address - Country:US
Practice Address - Phone:603-356-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3338122300000X
NH1213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty