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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

NPI # 1457360562
LBN Legal business name BANGOR FAMILY DENTISTRY
Authorized official MARK CARREIRA - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/07/2006
Last updated 05/04/2018 - About 8 years ago
Identifiers
ME License # 2098
ME Medicaid 104880000
ME Other 828257 UNITED CONCORDIA
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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