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Organization
MAINE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A.
Active
Organization
MAINE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE V GALLUP DMD (PRESIDENT/SURGEON)
(207) 514-7171
Entity
Organization
Contact information
Practice address
211 MOUNT AUBURN AVE, AUBURN, ME 04210-8521
(207) 514-7171
(207) 514-7177
Mailing address
211 MOUNT AUBURN AVENUE, AUBURN, ME 04210-8521
(207) 514-7171
(207) 514-7177
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/26/2006
Last updated
07/10/2012
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