Provider Demographics
NPI:1063559490
Name:VIZENTIN, ELIZABETH ELIANE (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ELIANE
Last Name:VIZENTIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 ROUTE 120
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03781-5440
Mailing Address - Country:US
Mailing Address - Phone:603-469-3074
Mailing Address - Fax:
Practice Address - Street 1:11 DUNNING ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2016
Practice Address - Country:US
Practice Address - Phone:603-542-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH35111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice