Full Name | |
---|---|
Speciality | Dentist |
Location | 8 Main Street, Sorrento, Maine |
Authorized Official Name and Position | Joseph Caruso (CFO) |
Authorized Official Contact | 2074223770 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 175 8 Main Street Sorrento ME 04677-0175 Ph: (207) 422-3770 | 8 Main Street Sorrento ME 04677 Ph: (207) 422-3770 |
NPI Number | 1215259072 |
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Provider Enumeration Date | 02/22/2010 |
Last Update Date | 02/22/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215259072 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 3740 (Maine) | Primary |