# MAINE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063468163
- **Authorized official:** BRUCE V GALLUP DMD (PRESIDENT/SURGEON)
- **Authorized official phone:** (207) 514-7171

## Contact information

- **Practice address:** 211 MOUNT AUBURN AVE, AUBURN, ME 04210-8521
- **Practice address phone:** (207) 514-7171
- **Practice address fax:** (207) 514-7177
- **Mailing address:** 211 MOUNT AUBURN AVENUE, AUBURN, ME 04210-8521
- **Mailing address phone:** (207) 514-7171
- **Mailing address fax:** (207) 514-7177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 07/10/2012