1154460731 NPI number — ANNE BARCLAY-FILLER,DMD,P.C.

Table of content: (NPI 1154460731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154460731 NPI number — ANNE BARCLAY-FILLER,DMD,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANNE BARCLAY-FILLER,DMD,P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154460731
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 547
Provider Second Line Business Mailing Address:
31 LOWELL ROAD
Provider Business Mailing Address City Name:
WINDHAM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03087-0547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-898-2072
Provider Business Mailing Address Fax Number:
603-893-6455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31 LOWELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDHAM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03087-1811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-898-2072
Provider Business Practice Location Address Fax Number:
603-893-6455
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FILLER
Authorized Official First Name:
ANNE
Authorized Official Middle Name:
BARCLAY
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
603-898-2072

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2035 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Z81744 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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