Provider Demographics
NPI:1720239213
Name:SOUTHERN NEW HAMPSHIRE SERVICES, INC.
Entity Type:Organization
Organization Name:SOUTHERN NEW HAMPSHIRE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GALE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HENNESSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-668-8010
Mailing Address - Street 1:40 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-6207
Mailing Address - Country:US
Mailing Address - Phone:603-668-8010
Mailing Address - Fax:603-623-1670
Practice Address - Street 1:40 PINE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-6207
Practice Address - Country:US
Practice Address - Phone:603-668-8010
Practice Address - Fax:603-623-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty