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General NPI Number Information
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NPI Number | 1922333202
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Entity Type | Individual
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Provider Name | JOHN S LARGEY DDS
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Gender | Male
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 10/05/2009
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Provider Practice Location Address
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Address Line | 885 UNION ST STE 225
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City | BANGOR
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State | ME
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Zip | 04401-3074
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Country | US
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Telephone | 207-942-6620
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Fax | 207-942-6264
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Provider Business Mailing Address
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Address Line | 885 UNION ST STE 225
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City | BANGOR
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State | ME
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Zip | 04401-3074
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Country | US
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Telephone | 207-942-6620
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Fax | 207-943-6264
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3522
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License Number State | ME
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