Provider Demographics
NPI:1114789179
Name:COLE, DIANNA MARIE (DA)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:MARIE
Last Name:COLE
Suffix:
Gender:F
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CUSHING RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:ME
Mailing Address - Zip Code:04864-4603
Mailing Address - Country:US
Mailing Address - Phone:207-273-5496
Mailing Address - Fax:207-273-5488
Practice Address - Street 1:807 CUSHING RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:ME
Practice Address - Zip Code:04864-4603
Practice Address - Country:US
Practice Address - Phone:207-273-5496
Practice Address - Fax:207-273-5488
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant