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General NPI Number Information
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NPI Number | 1952198632
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Entity Type | Organization
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Legal Business Name | MAINE DENTAL SURGERY CENTER PC
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 701 US ROUTE 1 STE 3A
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City | YARMOUTH
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State | ME
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Zip | 04096-7006
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Country | US
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Telephone | 207-740-8105
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Fax |
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Provider Business Mailing Address
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Address Line | 701 US ROUTE 1 STE 3A
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City | YARMOUTH
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State | ME
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Zip | 04096-7006
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Country | US
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Telephone | 207-740-8105
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. KATE LYDON
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Credential | RN
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Telephone | 207-740-8105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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