Organization · NPI-2

Angela J Santavicca DDS PLLC

Dentist, General Practice · Lebanon, NH

NPI number1639385289
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1639385289
Entity type
Organization (NPI-2)
Legal business name
Angela J Santavicca DDS PLLC
Organization subpart
No
Enumeration date
May 14, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice2648NHYes

Practice location

367 State Route 120
Unit C
Lebanon, NH 03766-1430

Phone 603-643-4142 · Fax 603-643-1740

Mailing address

367 State Route 120
Unit C
Lebanon, NH 03766-1430

Phone 603-643-4142 · Fax 603-643-1740

Authorized official

Jodi L Bergeron
Practice Manager
6036434142

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