Provider Demographics
NPI:1649254665
Name:FUCINI, STEPHEN ENRICO (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ENRICO
Last Name:FUCINI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 LYME RD
Mailing Address - Street 2:STE #2
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755
Mailing Address - Country:US
Mailing Address - Phone:603-643-0501
Mailing Address - Fax:603-643-4676
Practice Address - Street 1:73 LYME RD
Practice Address - Street 2:STE #2
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755
Practice Address - Country:US
Practice Address - Phone:603-643-0501
Practice Address - Fax:603-643-4676
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH25631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics