42 North Dental Care, PLLC
Dentist in Portland, ME. Organization (NPI-2).
NPI number1528130283
StatusActive
Last updated in NPPESDec 29, 2021
Details
- NPI
- 1528130283
- Entity type
- Organization (NPI-2)
- Legal business name
- 42 North Dental Care, PLLC
- Organization subpart
- No
- Enumeration date
- Nov 15, 2006
- Certification date
- Dec 29, 2021
- Last updated
- Dec 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 2954 | ME | Yes |
Other names
- Restorative And Aesthetic Dental Associates (Doing Business As)
- Burke, Philbrick & Corwin, P.A. (Former Legal Business Name)
Practice location
650 Brighton AvePortland, ME 04102-1035
Phone 207-773-6331
Mailing address
650 Brighton AvePortland, ME 04102-1035
Phone 207-773-6331
Authorized official
Michael Angelo Scialabba
Chief Clinical Officer
7816470772
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