Organization Name: | HANCOCK DENTAL, LLC |
NPI Number: | 1063681534 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PETER C. CUMMINGS (OWNER) |
Mailing Address: | 201 High St Ellsworth |
State: | ME US |
Postal Code: | 046051715 |
Phone Number: | 2076678778 |
Fax Number: | 2076672324 |
NPI Enumeration Date: | 02/28/2008 |
NPI Last Update Date: | 02/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 3506 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |