Organization
NORTHERN MAINE ORAL & FACIAL SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE L ROONEY (OFFICE MANAGER)
(207) 764-6337
Entity
Organization
Contact information
Practice address
181 ACADEMY STREET, SUITE #1, PRESQUE ISLE, ME 04769-3178
(207) 764-6337
(207) 764-1446
Mailing address
181 ACADEMY STREET, SUITE #1, PRESQUE ISLE, ME 04769-3178
(207) 764-6337
(207) 764-1446
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3426
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132730000
—
ME
01
—
2209645
AETNA
ME
01
—
9760835
CIGNA
ME
Enumeration date
05/21/2007
Last updated
01/06/2011
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