Lakes Region Dental Implant and Oral Surgery Center, P.a.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

Legal business name

LAKES REGION DENTAL IMPLANT AND ORAL SURGERY CENTER, P.A.

Practice address

369 Hounsell Ave
Suite 2
Gilford, NH 03249

Phone

(603) 527-8057

Fax

(603) 527-8159

NPI assigned

Apr 7, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Daniel Henry Detolla, DDS, MD

Title

President

Phone

(603) 436-3608

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Dave C Pak, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester, NH
  • NPI 1952542185
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1265721534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 HOUNSELL AVE",
            "address_2": "SUITE 2",
            "city": "GILFORD",
            "state": "NH",
            "postal_code": "03249",
            "telephone_number": "603-527-8057",
            "fax_number": "603-527-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 HOUNSELL AVE",
            "address_2": "SUITE 2",
            "city": "GILFORD",
            "state": "NH",
            "postal_code": "03249",
            "telephone_number": "603-527-8057",
            "fax_number": "603-527-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES REGION DENTAL IMPLANT AND ORAL SURGERY CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "DETOLLA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-436-3608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lachance, NP-C
• Laconia Cardiology
• Laconia Eye Associates PA
• Laconia Eye Associates PA
• Lakes Region Dental Care PLLC
• Lakes Region Opticians, Inc
• Lakes Region Surgical Associates, PC
• Connor John Lane
• Donna Marie Lang-Rice, PT
• Albert L Langley Jr.

• Oral and Maxillofacial Pathology Dentistry in Gilford, NH
• Providers in Gilford, NH by specialty
• Oral and Maxillofacial Pathology Dentistry in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.