Healthcare Provider Details

I. General information

NPI: 1578778767
Provider Name (Legal Business Name): CYNTHIA ANN BATTEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 NORTHPORT AVE
BELFAST ME
04915-6004
US

IV. Provider business mailing address

189 NORTHPORT AVE
BELFAST ME
04915-6004
US

V. Phone/Fax

Practice location:
  • Phone: 207-338-0273
  • Fax: 207-338-0275
Mailing address:
  • Phone: 207-338-0273
  • Fax: 207-338-0275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3397
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: