Healthcare Provider Details

I. General information

NPI: 1104852086
Provider Name (Legal Business Name): JOHN K GEE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 COMMERCIAL STREET
GLEN COVE ME
04846-0103
US

IV. Provider business mailing address

PO BOX 103
GLEN COVE ME
04846-0103
US

V. Phone/Fax

Practice location:
  • Phone: 207-594-2231
  • Fax: 207-594-4864
Mailing address:
  • Phone: 207-594-2231
  • Fax: 207-594-4864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2362
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: