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General NPI Number Information
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NPI Number | 1407076714
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Entity Type | Organization
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Legal Business Name | CHARLES H. DORR, DDS, PA
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 25 HADLEY LAKE ROAD
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City | MACHIAS
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State | ME
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Zip | 04654
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Country | US
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Telephone | 207-255-3352
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Fax | 207-255-8832
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Provider Business Mailing Address
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Address Line | PO BOX 528 25 HADLEY LAKE ROAD
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City | MACHIAS
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State | ME
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Zip | 04654-0528
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Country | US
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Telephone | 207-255-3352
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Fax | 207-255-8832
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES H. DORR JR.
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Credential | D.D.S.
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Telephone | 207-255-8832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2420
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License Number State | ME
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