Provider Demographics
NPI:1063699346
Name:STEFAN H. WITTNER D.M.D., P.A.
Entity type:Organization
Organization Name:STEFAN H. WITTNER D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WITTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-332-0106
Mailing Address - Street 1:31 HANSON ST
Mailing Address - Street 2:P.O. BOX 1966
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-2721
Mailing Address - Country:US
Mailing Address - Phone:603-332-0106
Mailing Address - Fax:
Practice Address - Street 1:31 HANSON ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-2721
Practice Address - Country:US
Practice Address - Phone:603-332-0106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty