Organization
ELLSWORTH BUCKSPORT DENTAL ASSOCIATES
Active
Parent organization
ELLSWORTH BUCKSPORT DENTAL ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLSWORTH BUCKSPORT DENTAL ASSOCIATES
Authorized official
MS. JODI L SAWYER (OFFICE MANAGER)
(207) 667-7117
Entity
Organization
Contact information
Practice address
11 MECHANIC STREET, BUCKSPORT, ME 04416
(207) 469-6191
(207) 469-3816
Mailing address
PO BOX 838, BUCKSPORT, ME 04416-0838
(207) 469-6191
(207) 469-3816
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3036
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120010000
—
ME
Enumeration date
09/29/2009
Last updated
09/29/2009
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