Provider Demographics
NPI:1144829045
Name:MACIEL, LINDA J (MSDH)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:MACIEL
Suffix:
Gender:F
Credentials:MSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MERRIT PARTKWAY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062
Mailing Address - Country:US
Mailing Address - Phone:603-821-0570
Mailing Address - Fax:
Practice Address - Street 1:20 MERRIT PKWY
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3029
Practice Address - Country:US
Practice Address - Phone:603-821-0570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02135124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH124Q00000XOtherDENTAL HYGIENE