Provider Demographics
NPI:1154625291
Name:HUDSON SMILES FAMILY DENTAL, PLCC
Entity type:Organization
Organization Name:HUDSON SMILES FAMILY DENTAL, PLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:APARNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KALLAKURCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-204-5005
Mailing Address - Street 1:36 LIBRARY ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-4243
Mailing Address - Country:US
Mailing Address - Phone:603-204-5005
Mailing Address - Fax:603-204-5006
Practice Address - Street 1:36 LIBRARY ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4243
Practice Address - Country:US
Practice Address - Phone:603-204-5005
Practice Address - Fax:603-204-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03708302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization