Provider Demographics
NPI:1720128663
Name:LEVESQUE FAMILY DENTISTRY
Entity type:Organization
Organization Name:LEVESQUE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEVESQUE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-882-7578
Mailing Address - Street 1:61 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-2561
Mailing Address - Country:US
Mailing Address - Phone:603-882-7578
Mailing Address - Fax:603-882-4215
Practice Address - Street 1:61 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-2561
Practice Address - Country:US
Practice Address - Phone:603-882-7578
Practice Address - Fax:603-882-4215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty