Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 04454 | NH |
NPI | 1144790619 |
---|---|
Provider Name | Francesca Failla |
First Address | Nashua, NH 03060-2720 |
Second Address | Nashua, NH 03060-2720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2018 |
Last Update Date | 27/11/2018 |