Organization
PENOBSCOT VALLEY DERMATOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DEAN PITTIS MD (DERMATOLOGIST)
(207) 942-0669
Entity
Organization
Contact information
Practice address
90 RIDGEWOOD DRIVE, BANGOR, ME 04401-2652
(207) 942-0669
(207) 947-3143
Mailing address
90 RIDGEWOOD DRIVE, BANGOR, ME 04401-2652
(207) 942-0669
(207) 947-3143
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME013153
ME
Other
Enumeration date
05/21/2009
Last updated
06/03/2009
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