Ellsworth Bucksport Dental Associates
Organization Active NPI General Practice Dentistry · Bucksport, ME
NPI 1124352737 · NPPES record last updated Sep 29, 2009
Key facts
- NPI
- 1124352737
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3036 (ME)
- Legal business name
- ELLSWORTH BUCKSPORT DENTAL ASSOCIATES
- Practice address
- 11 Mechanic Street
Bucksport, ME 04416 - Phone
- (207) 469-6191
- Fax
- (207) 469-3816
- NPI assigned
- Sep 29, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- ELLSWORTH BUCKSPORT DENTAL ASSOCIATES
Authorized official
- Name
- Ms. Jodi L Sawyer
- Title
- Office Manager
- Phone
- (207) 667-7117
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Ellsworth Bucksport Dental Associates
- Part of
- Ellsworth Bucksport Dental Associates
Locations
11 Mechanic St
Bucksport, ME 04416
Phone (207) 469-6191
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 3036 | ME | Yes |
Addresses
Primary practice location
11 Mechanic Street
Bucksport, ME 04416
Mailing address
PO Box 838
Bucksport, ME 04416-0838
Phone (207) 469-6191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120010000 | Medicaid | ME |
Other providers in Bucksport, ME
- Kathleen Denis
- Bonnie G Dubay-Brennan
- Emma K Duvefelt
- Kenneth Eaton Jr.
- Justin Ryan Elliott
- Foundation Dental, LLC
- Thomas Joseph Gaffney
- R Maxwell Goode
- GPC,LLC
- Thomas A Gray
All providers in Bucksport, ME · General Practice Dentistry in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.