Healthcare Provider Details

I. General information

NPI: 1912088733
Provider Name (Legal Business Name): ALEX HUTCHEON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 BAYVIEW STREET
YARMOUTH ME
04096-6993
US

IV. Provider business mailing address

247 PORTLAND ST STE 900
YARMOUTH ME
04096-8130
US

V. Phone/Fax

Practice location:
  • Phone: 207-846-0979
  • Fax: 207-846-5266
Mailing address:
  • Phone: 207-846-0979
  • Fax: 207-846-5266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3345
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: