1330 Dental Associates
Dentist in Portland, ME. Organization (NPI-2).
NPI number1629022611
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1629022611
- Entity type
- Organization (NPI-2)
- Legal business name
- 1330 Dental Associates
- Organization subpart
- No
- Enumeration date
- May 22, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 3052 | ME | Yes |
| 122300000X | Dentist | 2654 | ME | |
| 122300000X | Dentist | 3251 | ME | |
| 122300000X | Dentist | 3533 | ME | |
| 122300000X | Dentist | 3693 | ME |
Practice location
1330 Congress StreetPortland, ME 04102
Phone 207-773-3738 · Fax 207-773-5872
Mailing address
1330 Congress StreetPortland, ME 04102
Phone 207-773-3738 · Fax 207-773-5872
Authorized official
James G Bennas
President
2077733738
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