Provider Demographics
NPI:1700940871
Name:ACCENT FAMILY DENTISTRY
Entity Type:Organization
Organization Name:ACCENT FAMILY DENTISTRY
Other - Org Name:AESTHETIC FAMILY DENTISTRY PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:CARCAUD
Authorized Official - Last Name:HENNIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-743-6700
Mailing Address - Street 1:44C DOVER POINT RD
Mailing Address - Street 2:DOVER POINT OFFICE PARK
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820
Mailing Address - Country:US
Mailing Address - Phone:603-743-6700
Mailing Address - Fax:603-743-6710
Practice Address - Street 1:44C DOVER POINT RD
Practice Address - Street 2:DOVER POINT OFFICE PARK
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820
Practice Address - Country:US
Practice Address - Phone:603-743-6700
Practice Address - Fax:603-743-6710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3311122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30302643Medicaid