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Contact Information

ACADEMY DENTAL PA
179 ACEDEMY ST
PRESQUE ISLE, ME04769
 Phone: 207-764-3764
 Fax: 207-764-3367
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ACADEMY DENTAL PA

NPI # 1316955396
LBN Legal business name ACADEMY DENTAL PA
Authorized official SANDI BOUCHARD - (OFFICE/BUSINESS MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/04/2006
Last updated 10/02/2018 - About 8 years ago
Identifiers
ME Medicaid 129220000
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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