Angela J Santavicca DDS PLLC

Organization Active NPI General Practice Dentistry · Lebanon, NH

NPI 1639385289 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1639385289
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
2648 (NH)
Legal business name
ANGELA J SANTAVICCA DDS PLLC
Practice address
367 State Route 120
Unit C
Lebanon, NH 03766-1430
Phone
(603) 643-4142
Fax
(603) 643-1740
NPI assigned
May 14, 2007
Organization subpart
No

Authorized official

Name
Jodi L Bergeron
Title
Practice Manager
Phone
(603) 643-4142

Practitioners 3

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

National Provider Directory

Locations

367 State Route 120
Unit C
Lebanon, NH 03766
Phone (603) 643-4142

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 2648 NH Yes

Addresses

Primary practice location

367 State Route 120
Unit C
Lebanon, NH 03766-1430

Mailing address

367 State Route 120
Unit C
Lebanon, NH 03766-1430
Phone (603) 643-4142

Other identifiers

IdentifierTypeStateIssuer
30310640MedicaidNH

Other providers in Lebanon, NH

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

Sources for this page

Verify at the official NPI Registry.