Individual
HASKELL CHARLES KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
17 LEVESQUE DR STE 3, ELIOT, ME 03903-2075
(207) 439-0779
(207) 439-0883
Mailing address
17 LEVESQUE DR STE 3, ELIOT, ME 03903-2075
(207) 439-0779
(207) 439-0883
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2914
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030541
BLUE CROSS ID NUMBER
ME
Enumeration date
11/01/2006
Last updated
07/09/2007
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