Healthcare Provider Details

I. General information

NPI: 1770915878
Provider Name (Legal Business Name): NEW ENGLAND DENTURE CENTER OF AUBURN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 CENTER ST
AUBURN ME
04210-6316
US

IV. Provider business mailing address

730 CENTER ST
AUBURN ME
04210-6316
US

V. Phone/Fax

Practice location:
  • Phone: 207-777-0088
  • Fax:
Mailing address:
  • Phone: 207-777-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License Number5519
License Number StateME

VIII. Authorized Official

Name: BEATRICE TOKAYER
Title or Position: DENTURIST
Credential:
Phone: 207-286-9500