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DANIEL H DE TOLLA, D.D.S., M.D., PA

Ambulatory Health Care Facilities Clinic/Center Oral and Maxillofacial Surgery

Provider NPI: 1962620229

Organization Information:
Organization Name:  DANIEL H DE TOLLA, D.D.S., M.D., PA
Organization is not Subpart
Authorized Official:  DANIEL HENRY DE TOLLA  ORAL SURGEON  603-436-3608

Practice Location:
200 GRIFFIN ROAD SUITE 8 PORTSMOUTH, NH 03801 US
Tel: 603-436-3608  Fax: 603-436-3646

Business Mailing Address:
200 GRIFFIN ROAD SUITE 8 PORTSMOUTH, NH 03801 US
Tel: 603-436-3608  Fax: 603-436-3646

NPI Information:
NPI: 1962620229
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QS0112XAmbulatory Health Care Facilities
Clinic/Center
Oral and Maxillofacial Surgery
NH3472

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 261QS0112X

Type:

Classification:



Definition:



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