Provider Demographics
NPI:1285854265
Name:BERNIER, JANE N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:N
Last Name:BERNIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 NORTHPORT AVENUE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6010
Mailing Address - Country:US
Mailing Address - Phone:207-338-5955
Mailing Address - Fax:207-338-5955
Practice Address - Street 1:146 NORTHPORT AVENUE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6010
Practice Address - Country:US
Practice Address - Phone:207-338-5955
Practice Address - Fax:207-338-5955
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3089122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME12047000Medicaid