ELLSWORTH BUCKSPORT DENTAL ASSOCIATES; NPI #1124352737

Contact Information

ELLSWORTH BUCKSPORT DENTAL ASSOCIATES

11 MECHANIC STREET
BUCKSPORT, ME 04416

Phone: 207-469-6191
Fax: 207-469-3816
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	General Practice	1223G0001X

Indicates primary specialty

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NPI Profile & details for ELLSWORTH BUCKSPORT DENTAL ASSOCIATES

NPI # 1124352737

LBN Legal business name ELLSWORTH BUCKSPORT DENTAL ASSOCIATES

Authorized official JODI SAWYER - (OFFICE MANAGER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 09/29/2009

Last updated 09/29/2009 - About 17 years ago

Identifiers

ME	License #	3036
ME	Medicaid	120010000

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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