| Interdent Llc | |
|
12 Shuman Ave Augusta ME 04330-6020 | |
| (207) 623-7580 | |
| Not Available |
| Full Name | Interdent Llc |
|---|---|
| Speciality | Dentist |
| Location | 12 Shuman Ave, Augusta, Maine |
| Authorized Official Name and Position | Glen Frederic Abbott (PRESIDENT) |
| Authorized Official Contact | 2077769776 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interdent Llc 12 Shuman Ave Augusta ME 04330-6020 Ph: (207) 623-7580 | Interdent Llc 12 Shuman Ave Augusta ME 04330-6020 Ph: (207) 623-7580 |
| NPI Number | 1992099311 |
|---|---|
| Provider Enumeration Date | 06/02/2011 |
| Last Update Date | 06/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992099311 | NPI | - | NPPES |
| 435721099 | Other | ME | MAINE CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3757 (Maine) | Primary |
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