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Contact Information

BANGOR FAMILY DENTISTRY
83 RIDGEWOOD DR
BANGOR, ME04401-2652
 Phone: 207-947-4767
 Fax: 207-947-7112
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BANGOR FAMILY DENTISTRY · (Female)

NPI Number 1457360562
Status Active
Credentials
Entity Individual
Enumeration date 08/07/2006
Last updated 05/04/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • ME License # 2098
  • ME Medicaid 104880000
  • ME Other 828257 UNITED CONCORDIA
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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