Organization
GORHAM FAMILY AND COSMETIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER W PIDHAJECKY GENERAL DENTIST (OWNER)
(207) 839-3006
Entity
Organization
Contact information
Practice address
347 MAIN ST, GORHAM, ME 04038-1338
(207) 839-3006
(207) 839-4593
Mailing address
347 MAIN ST, GORHAM, ME 04038-1338
(207) 839-3006
(207) 839-4593
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235348749
GENERAL DENTIST
ME
01
—
1396853156
GENERAL DENTIST
ME
Enumeration date
08/15/2012
Last updated
08/15/2012
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