MEDICARE: PETER MATTHEW CARIGNAN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	3211	ME

General Provider Information

NPI Number	:	1295704914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER MATTHEW CARIGNAN DMD

Provider Business Mailing Address
First Line	:	1232A SHORE RD
Second Line	:	CAPE ELIZABETH DENTAL ASSOCIATES PA
City	:	CAPE ELIZABETH
State	:	ME
Zip	:	04107-2123
Country	:	US
Telephone Number	:	207-799-0760
Fax Number	:

Provider Business Practice Location Address
First Line	:	1232A SHORE RD
Second Line	:	CAPE ELIZABETH DENTAL ASSOCIATES PA
City	:	CAPE ELIZABETH
State	:	ME
Zip	:	04107-2123
Country	:	US
Telephone Number	:	207-799-0760
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	07/08/2007

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