Provider Demographics
NPI:1487450433
Name:DENTAL GROUP ASSOCIATES OF NEW HAMPSHIRE PC
Entity type:Organization
Organization Name:DENTAL GROUP ASSOCIATES OF NEW HAMPSHIRE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:941-893-2406
Mailing Address - Street 1:8429 LORRAINE RD STE 426
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-9010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5031
Practice Address - Country:US
Practice Address - Phone:941-504-6424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental