Provider Demographics
NPI:1699462333
Name:UPPER VALLEY DENTAL SLEEP CENTER, PLLC
Entity type:Organization
Organization Name:UPPER VALLEY DENTAL SLEEP CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-868-7785
Mailing Address - Street 1:642 HANOVER CENTER RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-4921
Mailing Address - Country:US
Mailing Address - Phone:509-868-7785
Mailing Address - Fax:
Practice Address - Street 1:71 LYME RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1253
Practice Address - Country:US
Practice Address - Phone:509-868-7785
Practice Address - Fax:603-643-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies