Organization
ANDROSCOGGIN ORAL AND MAXILLOFACIAL SURGEONS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN B KIPPAX DMD (OWNER)
(207) 784-9327
Entity
Organization
Contact information
Practice address
501 MAIN ST, LEWISTON, ME 04240
(207) 784-9327
(207) 777-1397
Mailing address
501 MAIN ST, LEWISTON, ME 04240
(207) 784-9327
(207) 777-1397
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3108
ME
Other
Enumeration date
07/06/2006
Last updated
08/22/2020
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