Organization
MID MAINE ORAL SURGERY
Active
Parent organization
MACAN HOLDINGS PA LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MACAN HOLDINGS PA LLC
Authorized official
DR. LUKE L'HEUREUX DMD, MD (ORAL SURGEON)
(207) 649-6664
Entity
Organization
Contact information
Practice address
244 KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4538
(207) 873-0117
Mailing address
18 EATON DR, WATERVILLE, ME 04901-4511
(207) 649-6664
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780995712
—
CT
Enumeration date
03/08/2022
Last updated
03/25/2022
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