LAKES REGION DENTAL IMPLANT AND ORAL SURGERY CENTER, P.A. (NPI# 1265721534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265721534 |
| Entity Type | Organization |
| Organization Name | LAKES REGION DENTAL IMPLANT AND ORAL SURGERY CENTER, P.A. |
| Practice Address |
369 Hounsell Ave Suite 2 Gilford NH 03249 |
| Practice Telephone | 6035278057 |
| Practice Fax Number | 6035278159 |
| Mailing Telephone | 6035278057 |
| Mailing Fax Number | 6035278159 |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |
| Authorized Official Name | DR. DANIEL HENRY DETOLLA (PRESIDENT) |
| Authorized Official Telephone | 6034363608 |
| Authorized Official Credential | DDS, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
Dental Providers |
| Street Address |
369 HOUNSELL AVE SUITE 2 |
| City | GILFORD |
| State | NH |
| Zip Code | 03249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285935866 | Children's Dentistry of The Lakes Region, Pllc | Dentist | 369 Hounsell Ave, Unit #1, Gilford, NH 03249 | 2010-11-12 |
| 1225575475 | Heather Corriveau | Specialist/Technologist | 369 Hounsell Ave, Gilford, NH 03249-6995 | 2017-01-26 |
| 1831447192 | Timothy Smith | Dentist | 369 Hounsell Ave, Suite #1, Gilford, NH 03249-6995 | 2012-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083102081 | Maryann Willard Lessard | Registered Nurse | 303 Old Lake Shore Rd G-9, Gilford, NH 03249 | 2018-04-25 |
| 1578943882 | Sandra Moore-beinoras | Nurse Practitioner | 25 Country Club Rd, Suite 601, Gilford, NH 03249 | 2015-06-02 |
| 1447671946 | Pam Seed | Speech-Language Pathologist | 177 Gunstock Hill Road, Gilford, NH 03249 | 2013-12-31 |
| 1104091578 | Denise Poudrier Normandin | Dietitian, Registered | 233 Stark St, Gilford, NH 03249 | 2008-04-28 |
| 1881893527 | Matthew Charles Jensen | Chiropractor | 14 Maple St Ste 100, Gilford, NH 03249 | 2007-07-12 |
| 1891917878 | Kathleen Kammeraad | Pharmacist | 1458 Lakeshore Road, Gilford, NH 03249 | 2007-05-02 |
| 1346331683 | Morton Aaron Levin | Dentist | 401 Gilford Avenue, Gilford, NH 03249 | 2006-09-28 |
| 1972529907 | Christopher Joseph Martino | Psychiatry & Neurology | 14 Maple St, Ste 400, Gilford, NH 03249 | 2006-07-14 |
| 1245205046 | Laconia Cardiology | Internal Medicine | 369 Hounsell Avenue, Suite #5, Gilford, NH 03249 | 2006-02-23 |
| 1629517412 | Jessica Lachance | Registered Nurse | 34 Robertson Dr, Gilford, NH 03249 | 2017-02-14 |
| Find all providers in zip 03249 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083606412 | John B Bassett | Dentist | 32 Stiles Rd, Suite 210, Salem, NH 03079-2892 | 2005-08-22 |
| 1649408584 | Rachel N Madden | Dentist | 39 Simon St, Ste 11, Nashua, NH 03060-3046 | 2009-06-30 |
| 1891908158 | William P Dobbin, D.m.d.,p.a. | Dentist | 4 Elliot Way, Suite 300, Manchester, NH 03103-3547 | 2007-05-07 |
| 1497974257 | John B. Bassett, Dmd, PC | Dentist | 32 Stiles Rd, Suite 210, Salem, NH 03079-2892 | 2007-04-24 |
| 1851483192 | Charles Hamman Henry | Dentist | 40 Mechanic St, Keene, NH 03431-3421 | 2006-09-28 |
| 1871606509 | Paul E Levy | Dentist | 187 N State St, Concord, NH 03301-5020 | 2006-08-16 |
| 1275576829 | Daniel H De Tolla | Dentist | 200 Griffin Rd, Suite 8, Portsmouth, NH 03801-7145 | 2006-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.