Healthcare Provider Details

I. General information

NPI: 1164616595
Provider Name (Legal Business Name): ELIZABETH FRANCO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 NARRAGANSETT TRL
BUXTON ME
04093-6505
US

IV. Provider business mailing address

41 LIBERTY LN #109
SOUTH PORTLAND ME
04106-2090
US

V. Phone/Fax

Practice location:
  • Phone: 207-929-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN4044
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: