Provider Demographics
NPI:1073659538
Name:DEIGHAN, WILLIAM ALEXANDER (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALEXANDER
Last Name:DEIGHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2566 KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:ME
Mailing Address - Zip Code:04444-4947
Mailing Address - Country:US
Mailing Address - Phone:207-234-2510
Mailing Address - Fax:
Practice Address - Street 1:37 BOWER ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4721
Practice Address - Country:US
Practice Address - Phone:207-945-5691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME30791223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MET31315Medicare UPIN
MEMM0471Medicare ID - Type Unspecified