Individual
DR. FREDERICK PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
700 MOUNT HOPE AVE, SUITE 610, BANGOR, ME 04401-5691
(207) 945-5952
Mailing address
700 MOUNT HOPE AVE, SUITE 610, BANGOR, ME 04401-5691
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2618
ME
Other
Enumeration date
08/09/2006
Last updated
07/09/2007
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