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General NPI Number Information
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NPI Number | 1275642456
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Entity Type | Organization
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Legal Business Name | ORAL & FACIAL SURGERY
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 885 UNION ST STE. 225
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City | BANGOR
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State | ME
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Zip | 04401-3083
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Country | US
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Telephone | 207-942-6620
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Fax | 207-942-6264
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Provider Business Mailing Address
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Address Line | 885 UNION ST STE. 225
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City | BANGOR
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State | ME
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Zip | 04401-3083
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Country | US
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Telephone | 207-942-6620
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Fax | 207-942-6264
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHARON K RING
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Credential |
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Telephone | 207-942-6620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3522
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License Number State | ME
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