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General NPI Number Information
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NPI Number | 1710457296
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Entity Type | Organization
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Legal Business Name | R. SCOTT CUNNINGHAM, D.D.S, P.A
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 4 CONGO AVE
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City | THOMASTON
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State | ME
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Zip | 04861-3625
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Country | US
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Telephone | 207-354-6453
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Fax | 207-354-8757
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Provider Business Mailing Address
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Address Line | 4 CONGO AVE
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City | THOMASTON
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State | ME
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Zip | 04861-3625
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Country | US
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Telephone | 207-354-6453
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Fax | 207-354-8757
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. RAYMOND SCOTT CUNNINGHAM
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Credential | DDS
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Telephone | 207-354-6453
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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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