Hanover Road Dental Health, PA
Dentist, General Practice in Lebanon, NH. Organization (NPI-2).
NPI number1164596227
StatusActive
Last updated in NPPESJun 2, 2015
Details
- NPI
- 1164596227
- Entity type
- Organization (NPI-2)
- Legal business name
- Hanover Road Dental Health, PA
- Organization subpart
- No
- Enumeration date
- Nov 20, 2006
- Last updated
- Jun 2, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 2601 | NH | Yes |
Other names
- Kenneth W. Olsen, D.M.D., P.A. (Former Legal Business Name)
Practice location
367 Route 120 Bldg. DLebanon, NH 03766
Phone 603-643-4362 · Fax 603-643-4340
Mailing address
367 Route 120 Bldg. DLebanon, NH 03766
Phone 603-643-4362 · Fax 603-643-4340
Authorized official
Terry Bradigan
Owner
6036434362
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