Provider Demographics
NPI:1124690961
Name:AMAZING FAMILY DENTAL PLLC
Entity type:Organization
Organization Name:AMAZING FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELFAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-485-7600
Mailing Address - Street 1:311 W RIVER RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2635
Mailing Address - Country:US
Mailing Address - Phone:603-485-7600
Mailing Address - Fax:603-485-8961
Practice Address - Street 1:311 W RIVER RD UNIT 2
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-2635
Practice Address - Country:US
Practice Address - Phone:603-485-7600
Practice Address - Fax:603-485-8961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental