Provider Demographics
NPI:1861890410
Name:ULYIMATE DENTAL CARE LLC
Entity type:Organization
Organization Name:ULYIMATE DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSTAFA
Authorized Official - Middle Name:H
Authorized Official - Last Name:EL-SHERIF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,MSCD,PHD
Authorized Official - Phone:603-731-0100
Mailing Address - Street 1:410 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3483
Mailing Address - Country:US
Mailing Address - Phone:603-224-1851
Mailing Address - Fax:603-224-7240
Practice Address - Street 1:410 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3483
Practice Address - Country:US
Practice Address - Phone:603-224-1851
Practice Address - Fax:603-224-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty