# MAINE MEDICAL PARTNERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MMC ORAL SURGERY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790889376
- **Authorized official:** STEPHEN J KASABIAN (PRESIDENT)
- **Authorized official phone:** (207) 761-0650

## Contact information

- **Practice address:** 22 BRAMHALL ST, DEPT OF SURGERY, PORTLAND, ME 04102-3134
- **Practice address phone:** (207) 871-4078
- **Practice address fax:** (207) 871-6389
- **Mailing address:** 39 WALLACE AVE, SOUTH PORTLAND, ME 04106-6143
- **Mailing address phone:** (207) 761-0650
- **Mailing address fax:** (207) 761-8198

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2006
- **Last updated:** 08/22/2020