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General NPI Number Information
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NPI Number | 1356496244
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Entity Type | Organization
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Legal Business Name | HOLDEN DENTAL CENTER, P.A.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 498 ESSEX ST #103
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City | BANGOR
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State | ME
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Zip | 04401-3990
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Country | US
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Telephone | 207-990-2727
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Fax | 207-990-2729
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Provider Business Mailing Address
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Address Line | 498 ESSEX ST #103
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City | BANGOR
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State | ME
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Zip | 04401-3990
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Country | US
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Telephone | 207-990-2727
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Fax | 207-990-2729
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN THOMAS HAUGE
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Credential | D.M.D.
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Telephone | 207-990-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 3319
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License Number State | ME
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