Robert F. Provencher JR., DDS
NPI #1427031137 in Manchester, New Hampshire
Provider Information
- NPI Number
- 1427031137
- Entity Type
- Individual
- Name
- Robert F. Provencher JR., DDS
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Credential
- DDS
- Enumeration Date
- Nov 28, 2005
- Last Updated
- Jul 9, 2007
Practice Location
- Address
- 1 ELLIOT WAY
- Address 2
- 2ND FLOOR
- City
- Manchester
- State
- New Hampshire
- ZIP Code
- 03103-3502
- Phone
- (603) 625-8462
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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