CONWAY VILLAGE DENTAL NPI 1528480902

NPI Information

NPI: 1528480902
Provider Name: CONWAY VILLAGE DENTAL

Former Legal Business Name: LIVING RESPONSIBLY PLLC

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
21A POLIQUIN DRIVE
CONWAY, NH
ZIP 03818
Phone: (603) 447-6707
Get Directions

CONWAY VILLAGE DENTAL is a general practice dentist in Conway, NH. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CONWAY VILLAGE DENTAL NPI is 1528480902. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Living Responsibly Pllc.

The provider's business location address is:

21A POLIQUIN DRIVE
CONWAY, NH
ZIP 03818
Phone: (603) 447-6707
Fax: (603) 447-8376

The provider's authorized official is Julie Ann Dudevoir-badger .
The authorized official title is Ceo and has the following contact phone number (603) 447-6707.

The enumeration date for this NPI number is 1/20/2014 and was last updated on 2/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist				No
2	1223G0001X	Dentist	General Practice			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3080677	MEDICAID	NEW HAMPSHIRE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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