# MID MAINE ORAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MACAN HOLDINGS PA LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336896489
- **Legal business name:** MACAN HOLDINGS PA LLC
- **Authorized official:** DR. LUKE L'HEUREUX DMD, MD (ORAL SURGEON)
- **Authorized official phone:** (207) 649-6664

## Contact information

- **Practice address:** 244 KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4538
- **Practice address phone:** (207) 873-0117
- **Mailing address:** 18 EATON DR, WATERVILLE, ME 04901-4511
- **Mailing address phone:** (207) 649-6664

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/08/2022
- **Last updated:** 03/25/2022