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General NPI Number Information
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NPI Number | 1427844349
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Entity Type | Organization
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Legal Business Name | CAPITAL CITY SMILES & WELLNESS LLC
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 11 MIDDLE ST # 1
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City | AUGUSTA
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State | ME
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Zip | 04330-5210
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Country | US
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Telephone | 207-522-9749
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Fax |
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Provider Business Mailing Address
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Address Line | 47 PINE HILL DR
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City | BATH
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State | ME
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Zip | 04530-2080
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Country | US
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Telephone | 207-522-9749
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACI L DEMPSEY
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Credential | RDH
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Telephone | 207-522-9749
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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 |
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License Number State |
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