Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 1211 | NH |
NPI | 1003939406 |
---|---|
Provider Name | Dr. Donald M. Humen |
First Address | Nashua, NH 03064-1100 |
Second Address | Nashua, NH 03062-1396 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |