Provider Demographics
NPI:1104430131
Name:PLAISTOW DENTAL IMPLANT AND ORAL SURGERY CENTER
Entity type:Organization
Organization Name:PLAISTOW DENTAL IMPLANT AND ORAL SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STIEFEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-257-7080
Mailing Address - Street 1:166 PLAISTOW RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2843
Mailing Address - Country:US
Mailing Address - Phone:603-257-7080
Mailing Address - Fax:603-257-7080
Practice Address - Street 1:166 PLAISTOW RD UNIT 3
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2843
Practice Address - Country:US
Practice Address - Phone:603-257-7080
Practice Address - Fax:603-257-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery