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NPI Code Detail

MEDICARE: DR. CHRISTOPHER ALLEN COTTERILL D.M.D.

MEDICARE: DR. CHRISTOPHER ALLEN COTTERILL D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist7968KY
21223P0221XPediatric DentistryDEN.00203359CO
31223P0221XPediatric Dentistry9401NC
41223P0221XPediatric Dentistry754KY
51223P0221XPediatric DentistryDEN5092ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124054051
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER ALLEN COTTERILL D.M.D.
Provider Business Mailing Address
First Line : 1 COLLEGE ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2617
Country : US
Telephone Number : 207-221-4784
Fax Number : 207-523-1915
Provider Business Practice Location Address
First Line : 1 COLLEGE ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2617
Country : US
Telephone Number : 207-221-4747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 12/05/2023

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