Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 01839 | NH |
NPI | 1003391590 |
---|---|
Provider Name | Annette Lisa Cole |
First Address | Littleton, NH 03561-4143 |
Second Address | Littleton, NH 03561-4143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2018 |
Last Update Date | 01/10/2018 |