Provider Demographics
NPI:1780700450
Name:COASTAL DENTAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:COASTAL DENTAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-436-6997
Mailing Address - Street 1:2837 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5648
Mailing Address - Country:US
Mailing Address - Phone:603-436-6997
Mailing Address - Fax:603-436-6964
Practice Address - Street 1:2837 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5648
Practice Address - Country:US
Practice Address - Phone:603-436-6997
Practice Address - Fax:603-436-6964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty