Organization
FACIAL AND ORAL SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R. RUBERT BERUBE (VICE PRESIDENT / SECRETARY)
(207) 622-5814
Entity
Organization
Contact information
Practice address
5 COMMUNITY DR, AUGUSTA, ME 04330-8087
(207) 622-5814
(207) 621-4360
Mailing address
5 COMMUNITY DR, AUGUSTA, ME 04330-8087
(207) 622-5814
(207) 621-4360
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3423
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2091238
AETNA NUMBER
ME
01
—
826700
UNITED CONCORDIA
ME
01
—
K0832
ANTHEM BLUE CROSS
ME
01
—
M53500
CIGNA HEALTHCARE
ME
Enumeration date
04/13/2007
Last updated
07/24/2008
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