Maine Oral & Maxillofacial Surgery Associates, P.a.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MAINE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A.

Practice address

211 Mount Auburn Ave
Auburn, ME 04210-8521

Phone

(207) 514-7171

Fax

(207) 514-7177

NPI assigned

May 26, 2006

Last updated

Jul 10, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bruce V Gallup, DMDNPI 1790788487

Title

President/Surgeon

Phone

(207) 514-7171

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce V Gallup, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Auburn, ME
  • NPI 1790788487
  Authorized official Same address or phone
• Tony Kang, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Westford, MA
  • NPI 1508243254
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1063468163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MOUNT AUBURN AVENUE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108521",
            "telephone_number": "207-514-7171",
            "fax_number": "207-514-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MOUNT AUBURN AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108521",
            "telephone_number": "207-514-7171",
            "fax_number": "207-514-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "GALLUP",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT/SURGEON",
        "authorized_official_telephone_number": "207-514-7171",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Dawn Macvane, LCSW
• Bhavagan S Maganti, MD
• Klein Unabia Magsalay, PT
• Gary Brian Magur
• Tatjana Cvjetinovic Mahon
• John Robert Malta, D.O.
• Eileen M Manglass, LCSW
• Manual Physical Therapy, LLC
• Katherine Eileen Marble, LCSW
• Paula Marcus-Platz, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Auburn, ME
• Providers in Auburn, ME by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.