Provider Demographics
NPI:1871702811
Name:JENNIFER A MCCONATHY DDS
Entity type:Organization
Organization Name:JENNIFER A MCCONATHY DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCONATHY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-742-3321
Mailing Address - Street 1:51 WEBB PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2454
Mailing Address - Country:US
Mailing Address - Phone:603-742-3321
Mailing Address - Fax:603-749-6806
Practice Address - Street 1:51 WEBB PL
Practice Address - Street 2:SUITE 200
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2454
Practice Address - Country:US
Practice Address - Phone:603-742-3321
Practice Address - Fax:603-749-6806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH32881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty