Healthcare Provider Details

I. General information

NPI: 1730102138
Provider Name (Legal Business Name): HAMPDEN FAMILY DENTISTRY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 WESTERN AVE
HAMPDEN ME
04444-1422
US

IV. Provider business mailing address

27 WESTERN AVE
HAMPDEN ME
04444-1422
US

V. Phone/Fax

Practice location:
  • Phone: 207-862-2600
  • Fax: 207-862-2602
Mailing address:
  • Phone: 207-862-2600
  • Fax: 207-862-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateME

VIII. Authorized Official

Name: DR. RANDALL PETER CUTRI
Title or Position: TREASURER
Credential: D.M.D.
Phone: 207-862-2600