Provider Demographics
NPI:1053131185
Name:TIWARI, ANUSHREE
Entity type:Individual
Prefix:
First Name:ANUSHREE
Middle Name:
Last Name:TIWARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2768
Mailing Address - Country:US
Mailing Address - Phone:603-760-6000
Mailing Address - Fax:603-760-6001
Practice Address - Street 1:460 ELM ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2768
Practice Address - Country:US
Practice Address - Phone:603-760-6000
Practice Address - Fax:603-760-6001
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH051281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice