Great Outdoors Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

04093 Issued in NH

Legal business name

GREAT OUTDOORS PEDIATRIC DENTISTRY

Practice address

6 Old Rochester Rd
301
Dover, NH 03820-2027

Phone

(603) 343-1228

NPI assigned

Apr 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Patrick T Wilson, DMD

Title

Owner, President

Phone

(303) 913-9951

Specialties & licenses 1

Addresses

Other names 1

• Patrick T Wilson PLLC Doing business as

Locations

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428278400000",
    "number": "1831584929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 OLD ROCHESTER RD",
            "address_2": "301",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202027",
            "telephone_number": "603-343-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 OLD ROCHESTER RD",
            "address_2": "301",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202027",
            "telephone_number": "603-343-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT OUTDOORS PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "303-913-9951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NH",
            "license": "04093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patrick T Wilson PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Michael Gray, M.D.
• Rebecca Gray, APRN
• Katelyn Graziani, PT, DPT
• Great Bay Neurosurgical Associates, P.a.
• Great Bay Services
• Great Smiles, PLLC
• Greater Seacoast Community Health
• Hannah Greer
• Peter A Grieve, RPH
• Stefanie Griffin, PHD

• Pediatric Dentistry in Dover, NH
• Providers in Dover, NH by specialty
• Pediatric Dentistry in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; 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.