Organization
MAINEHEALTH
Active
Other names
Coastal Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (SENIOR VICE PRESIDENT & CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
125 NORTHPORT AVE STE 107, BELFAST, ME 04915-6002
(207) 338-3368
(207) 338-6207
Mailing address
118 NORTHPORT AVE, BELFAST, ME 04915-6009
(207) 338-3368
(207) 338-6207
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/09/2018
Last updated
04/30/2019
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