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General NPI Number Information
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NPI Number | 1730702762
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Entity Type | Organization
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Legal Business Name | ATLANTIC PINES ORAL SURGERY AND ANESTHESIA
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 1931 SANFORD RD
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City | WELLS
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State | ME
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Zip | 04090-6488
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Country | US
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Telephone | 267-368-4337
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Fax |
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Provider Business Mailing Address
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Address Line | 1931 SANFORD RD
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City | WELLS
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State | ME
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Zip | 04090-6488
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSE SNOW
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Credential | DMD
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Telephone | 207-618-8075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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