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General NPI Number Information
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NPI Number | 1538632997
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Entity Type | Organization
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Legal Business Name | DIRIGO PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 701 US ROUTE 1 STE 3
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City | YARMOUTH
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State | ME
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Zip | 04096-6927
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Country | US
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Telephone | 207-251-0840
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Fax |
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Provider Business Mailing Address
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Address Line | 188 MILLIKEN RD
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City | NORTH YARMOUTH
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State | ME
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Zip | 04097-6717
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Country | US
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Telephone | 207-251-0840
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL DOWLING
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Credential | DMD
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Telephone | 207-251-0840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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