| Lakeside Dental Llc | |
|
1051 Western Ave Manchester ME 04351-3403 | |
| (207) 310-0842 | |
| Not Available |
| Full Name | Lakeside Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1051 Western Ave, Manchester, Maine |
| Authorized Official Name and Position | Ryan Salamon (MANAGER) |
| Authorized Official Contact | 2073100842 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Dental Llc 60 Willow Ln Portland ME 04102-2629 Ph: (207) 310-0842 | Lakeside Dental Llc 1051 Western Ave Manchester ME 04351-3403 Ph: (207) 310-0842 |
| NPI Number | 1891262804 |
|---|---|
| Provider Enumeration Date | 10/29/2018 |
| Last Update Date | 10/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891262804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Central Maine Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Rockwood Dr, Manchester, ME 04351 Phone: 786-382-7819 |