| Maine Center For Dental Medicine Pa | |
|
59 Pleasant St Skowhegan ME 04976-1227 | |
| (207) 474-9503 | |
| (207) 474-5271 |
| Full Name | Maine Center For Dental Medicine Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 59 Pleasant St, Skowhegan, Maine |
| Authorized Official Name and Position | Mohammed Mansoorul Imam (PRESIDENT/DENTIST) |
| Authorized Official Contact | 2074749503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maine Center For Dental Medicine Pa 59 Pleasant St Skowhegan ME 04976-1227 Ph: (207) 474-9503 | Maine Center For Dental Medicine Pa 59 Pleasant St Skowhegan ME 04976-1227 Ph: (207) 474-9503 |
| NPI Number | 1558605642 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558605642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DEN4231 (Maine) | Primary |
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