Individual
ALBERT FREDERICK LACIVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19 FAHEY ST, BELFAST, ME 04915-6028
(207) 338-3669
Mailing address
50 BAYVIEW ST, BELFAST, ME 04915-6712
(207) 338-3101
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3361
ME
Other
Enumeration date
07/01/2006
Last updated
07/08/2007
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