Healthcare Provider Details

I. General information

NPI: 1427264308
Provider Name (Legal Business Name): RONALD G SAWYER DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 WASHINGTON ST
BATH ME
04530-1641
US

IV. Provider business mailing address

304 WASHINGTON ST
BATH ME
04530-1641
US

V. Phone/Fax

Practice location:
  • Phone: 207-442-7581
  • Fax:
Mailing address:
  • Phone: 207-442-7581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number2563
License Number StateME

VIII. Authorized Official

Name: DR. RONALD GEORGE SAWYER
Title or Position: PRESIDENT
Credential: DMD
Phone: 207-442-7581