Healthcare Provider Details

I. General information

NPI: 1194921023
Provider Name (Legal Business Name): ROBERT M. DEWITT, JR., DDS, MS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MAIN STREET
NEWCASTLE ME
04553
US

IV. Provider business mailing address

PO BOX 467
NEWCASTLE ME
04553-0467
US

V. Phone/Fax

Practice location:
  • Phone: 207-563-1551
  • Fax: 207-563-2573
Mailing address:
  • Phone: 207-563-1551
  • Fax: 207-563-2573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT M. DEWITT JR.
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 207-563-1551