Provider Demographics
NPI:1750587168
Name:NEW HAMPSHIRE DENTAL SOCIETY FOUNDATION, INC.
Entity type:Organization
Organization Name:NEW HAMPSHIRE DENTAL SOCIETY FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-225-5961
Mailing Address - Street 1:23 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3721
Mailing Address - Country:US
Mailing Address - Phone:603-225-5961
Mailing Address - Fax:603-226-4880
Practice Address - Street 1:23 S STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3721
Practice Address - Country:US
Practice Address - Phone:603-225-5961
Practice Address - Fax:603-226-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30532844Medicaid