Individual
DR. TESSIE BURACZEWSKI STANSBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
716 STEVENS AVE, PORTLAND, ME 04103
(207) 221-4737
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
(207) 482-7898
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS039922
PA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DEN4593
ME
Other
Enumeration date
08/25/2014
Last updated
10/13/2018
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