Provider Demographics
NPI:1326276924
Name:DENTAL SPECIALISTS OF YARMOUTH, LLC
Entity Type:Organization
Organization Name:DENTAL SPECIALISTS OF YARMOUTH, LLC
Other - Org Name:DENTAL SPECIALISTS OF BIDDEFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STEUER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-308-8245
Mailing Address - Street 1:413 ALRED STREET
Mailing Address - Street 2:UNIT B1A, PARK 111
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:413 ALRED STREET
Practice Address - Street 2:UNIT B1A, PARK 111
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005
Practice Address - Country:US
Practice Address - Phone:207-879-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME38101223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty