Backbay Dental, LLC
Clinic/Center, Dental in Wolfeboro, NH. Organization (NPI-2).
NPI number1164039277
StatusActive
Last updated in NPPESSep 23, 2020
Details
- NPI
- 1164039277
- Entity type
- Organization (NPI-2)
- Legal business name
- Backbay Dental, LLC
- Organization subpart
- No
- Enumeration date
- Sep 23, 2020
- Certification date
- Sep 23, 2020
- Last updated
- Sep 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Back Bay Dental (Doing Business As)
Practice location
51 Mill StWolfeboro, NH 03894-4361
Phone 603-569-1554
Mailing address
51 Mill StWolfeboro, NH 03894-4361
Phone 603-569-1554
Authorized official
Nicholas Thomas Ciancarelli
Manager
6035691554
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