| Doctor Name: | MR. PHILIP SANGUEDOLCE |
| NPI Number: | 1356550834 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 5023 |
| Business Practice Address: | 37 Route 236 Suite 215 Kittery, ME - 039046000 |
| Business Phone Number: | 2074519898 |
| Business Fax Number: | 2074380257 |
| Mailing Address: | 37 Route 236, Suite 215 KITTERY |
| State: | ME |
| Postal Code: | 039046000 |
| Phone Number: | 2074519898 |
| Fax Number: | 2074380257 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | 5023 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |