Provider Demographics
NPI:1982906467
Name:WHITE BIRCH ORAL SURGERY, PLLC
Entity Type:Organization
Organization Name:WHITE BIRCH ORAL SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:P
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-740-1414
Mailing Address - Street 1:44 DOVER POINT RD UNIT C
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4669
Mailing Address - Country:US
Mailing Address - Phone:603-740-1414
Mailing Address - Fax:603-740-0111
Practice Address - Street 1:44 DOVER POINT RD UNIT C
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4669
Practice Address - Country:US
Practice Address - Phone:603-740-1414
Practice Address - Fax:603-740-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH32611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty