Coos County Family Health Services

Organization Active NPI General Practice Dentistry · Berlin, NH

NPI 1003019837 · NPPES record last updated Nov 17, 2016

Key facts

NPI
1003019837
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
1275 (NH)
Legal business name
COOS COUNTY FAMILY HEALTH SERVICES
Practice address
73 Main Street
Berlin, NH 03570
Phone
(603) 752-2424
Fax
(603) 752-2436
NPI assigned
Jun 8, 2007
Organization subpart
Yes
Parent organization (as reported)
COOS COUNTY FAMILY HEALTH SERVICES

Authorized official

Name
Kenneth Gordon
Title
Ceo
Phone
(603) 752-3669

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Part of
Coos County Family Health Services Inc

Locations

133 Pleasant St
Berlin, NH 03570
Phone (603) 752-2040

73 Main St
Berlin, NH 03570
Phone (603) 752-2040

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193200000X MULTI-SPECIALTY GROUP
122300000X 04258 NH
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X 1275 NH Yes
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X 01275 NH

Addresses

Primary practice location

73 Main Street
Berlin, NH 03570

Mailing address

133 Pleasant Street
Berlin, NH 03570
Phone (603) 752-2040

Other identifiers

IdentifierTypeStateIssuer
30301511MedicaidNH

Other providers in Berlin, NH

All providers in Berlin, NH · General Practice Dentistry in New Hampshire

Sources for this page

Verify at the official NPI Registry.