Organization
NORTHEAST ORAL & MAXILLOFACIAL SURGERY ASSOCIATES P.A.
Active
Other names
Northeast Oral & Maxillofacial Surgery P.A.(remove)
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM A. DEIGHAN D.M.D. (CO-OWNER/SURGEON)
(207) 945-5691
Entity
Organization
Contact information
Practice address
37 BOWER ST, BANGOR, ME 04401-4721
(207) 945-5691
(207) 942-9525
Mailing address
37 BOWER ST, BANGOR, ME 04401-4721
(207) 945-5691
(207) 942-9525
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
3079
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246780099
—
ME
Enumeration date
02/15/2007
Last updated
12/17/2012
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