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Organization

42 NORTH DENTAL CARE, PLLC

Active
Other names
Burke, Philbrick & Corwin, P.A., Restorative and Aesthetic Dental Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL ANGELO SCIALABBA DDS (CHIEF CLINICAL OFFICER)
(781) 647-0772
Entity
Organization

Contact information

Practice address
650 BRIGHTON AVE, PORTLAND, ME 04102-1035
(207) 773-6331
Mailing address
650 BRIGHTON AVE, PORTLAND, ME 04102-1035
(207) 773-6331

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2954
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251480099
ME
05
315660099
ME
05
329670099
ME
Enumeration date
11/15/2006
Last updated
12/29/2021
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