Academy Dental PA

Organization Active NPI General Practice Dentistry · Presque Isle, ME

NPI 1316955396 · NPPES record last updated Oct 2, 2018

Key facts

NPI
1316955396
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
ACADEMY DENTAL PA
Practice address
179 Acedemy St
Presque Isle, ME 04769
Phone
(207) 764-3764
Fax
(207) 764-3367
NPI assigned
Aug 4, 2006
Organization subpart
No

Authorized official

Name
Sandi Bouchard, DO
Title
Office/Business Manager
Phone
(207) 764-3764

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

179 Academy St
Presque Isle, ME 04769
Phone (207) 227-1332

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

179 Acedemy St
Presque Isle, ME 04769

Mailing address

179 Acedemy St
Presque Isle, ME 04769
Phone (207) 764-3764

Other identifiers

IdentifierTypeStateIssuer
129220000MedicaidME

Other providers in Presque Isle, ME

All providers in Presque Isle, ME · General Practice Dentistry in Maine

Sources for this page

Verify at the official NPI Registry.