Provider Demographics
NPI:1285204735
Name:INVERNESS DENTAL ARTS
Entity Type:Organization
Organization Name:INVERNESS DENTAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-314-7873
Mailing Address - Street 1:3 BRIGHAM ST
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5114
Mailing Address - Country:US
Mailing Address - Phone:207-314-7873
Mailing Address - Fax:
Practice Address - Street 1:3 BRIGHAM ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5114
Practice Address - Country:US
Practice Address - Phone:207-313-3352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental