Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 01266 | NH |
NPI | 1073904082 |
---|---|
Provider Name | Bonnie L Seekamp |
First Address | Manchester, NH 03104 |
Second Address | Manchester, NH 03104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2015 |
Last Update Date | 12/02/2015 |