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Contact Information

MID MAINE ORAL SURGERY
244 KENNEDY MEMORIAL DR
WATERVILLE, ME04901-4538
 Phone: 207-873-0117
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Dental

261QD0000X
Indicates primary specialty

NPI Profile & details for MID MAINE ORAL SURGERY · (Female)

NPI # 1336896489
Status Active
Credentials
Entity Individual
Enumeration date 03/08/2022
Last updated 03/25/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • CT Medicaid 1780995712
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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