Healthcare Provider Details

I. General information

NPI: 1598991622
Provider Name (Legal Business Name): SMILE AGAIN DENTURES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 06/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 WEBSTER ST
LEWISTON ME
04240-1600
US

IV. Provider business mailing address

801 WEBSTER ST
LEWISTON ME
04240-1600
US

V. Phone/Fax

Practice location:
  • Phone: 207-514-0660
  • Fax: 207-514-0660
Mailing address:
  • Phone: 207-514-0660
  • Fax: 207-514-0660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH ADKINS
Title or Position: PRESIDENT
Credential: LD
Phone: 207-514-0660