Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0300X | Periodontist | 14549 | MA |
Y | 1223P0300X | Periodontist | 2308 | NH |
NPI | 1033166186 |
---|---|
Provider Name | Dr. George H. Maxfield |
First Address | Chester, NH 03036-4035 |
Second Address | Chester, NH 03036-4035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 08/07/2007 |