Healthcare Provider Details

I. General information

NPI: 1407245897
Provider Name (Legal Business Name): SNORING AND SLEEP APNEA SOLUTIONS FOR MAINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2015
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PARK ST
WATERVILLE ME
04901-6039
US

IV. Provider business mailing address

12 PARK ST
WATERVILLE ME
04901-6039
US

V. Phone/Fax

Practice location:
  • Phone: 207-616-0942
  • Fax: 207-873-0540
Mailing address:
  • Phone: 207-616-0942
  • Fax: 207-873-0540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2817
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number2817
License Number StateME

VIII. Authorized Official

Name: CHARLES J RUFF
Title or Position: OWNER
Credential: DMD
Phone: 207-616-0942