Provider Demographics
NPI:1093122848
Name:ISLAND POINT DENTISTRY LLC, P.A.
Entity Type:Organization
Organization Name:ISLAND POINT DENTISTRY LLC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-284-4007
Mailing Address - Street 1:110 MAIN ST
Mailing Address - Street 2:SUITE 1218
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3509
Mailing Address - Country:US
Mailing Address - Phone:207-284-4007
Mailing Address - Fax:207-284-4096
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:SUITE 1218
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3509
Practice Address - Country:US
Practice Address - Phone:207-284-4007
Practice Address - Fax:207-284-4096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental