| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 25 Stone St, Augusta, Maine |
| Authorized Official Name and Position | David Lee (COO) |
| Authorized Official Contact | 7322071689 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
290 Bridgton Rd Ste 2 Westbrook ME 04092-3754 Ph: (732) 207-1689 | 25 Stone St Augusta ME 04330-6114 Ph: (207) 622-9210 |
| NPI Number | 1154794758 |
|---|---|
| Provider Enumeration Date | 11/04/2015 |
| Last Update Date | 12/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154794758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 302R00000X | Health Maintenance Organization | DEN4051 (Maine) | Secondary |
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Family Dental Practice, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 43 Grove St, Augusta, ME 04330 Phone: 207-622-7022 Fax: 207-626-5361 | |
Christopher R Logan, Dmd, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 137 Western Ave, Augusta, ME 04330 Phone: 207-622-3879 | |
Hasenfus Family Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 41 Fuller Rd, Augusta, ME 04330 Phone: 207-622-1711 Fax: 207-626-5893 | |
Lighthouse Pediatric Dentistry Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 Industrial Dr, Augusta, ME 04330 Phone: 207-622-0303 | |
State Street Dental Care, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 278 State St, Augusta, ME 04330 Phone: 207-622-9215 |