Provider Demographics
NPI:1124105952
Name:AHERN & NICHOLS FAMILY DENTISTRY,P.A.
Entity type:Organization
Organization Name:AHERN & NICHOLS FAMILY DENTISTRY,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AHERN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-432-5039
Mailing Address - Street 1:30 PINKERTON ST
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1504
Mailing Address - Country:US
Mailing Address - Phone:603-432-5039
Mailing Address - Fax:603-425-2873
Practice Address - Street 1:30 PINKERTON ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1504
Practice Address - Country:US
Practice Address - Phone:603-432-5039
Practice Address - Fax:603-425-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAZZ3871OtherBLUE CROSS/BLUE SHIELD