Organization
FARMINGTON ORAL & FACIAL SURGERY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ELLIS JR. (PRESIDENT)
(207) 779-1111
Entity
Organization
Contact information
Practice address
444 WILTON RD, FARMINGTON, ME 04938-6135
(207) 779-1111
Mailing address
444 WILTON RD, FARMINGTON, ME 04938-6135
(207) 779-1111
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/15/2011
Last updated
07/15/2011
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