Provider Demographics
NPI:1730280546
Name:PAISNER DENTAL ASSOCIATES PC
Entity type:Organization
Organization Name:PAISNER DENTAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIOT
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAISNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-883-6546
Mailing Address - Street 1:78 NORTHEASTERN BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3791
Mailing Address - Country:US
Mailing Address - Phone:603-883-6546
Mailing Address - Fax:603-595-1826
Practice Address - Street 1:78 NORTHEASTERN BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3791
Practice Address - Country:US
Practice Address - Phone:603-883-6546
Practice Address - Fax:603-595-1826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH15041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH89191931Medicaid
NHPAIS191931OtherBCBS/GOVERNMENT