Provider Demographics
NPI:1386847846
Name:STEGEMANN AND SHUMAN ORTHODONTICS PA
Entity Type:Organization
Organization Name:STEGEMANN AND SHUMAN ORTHODONTICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEGEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-797-5577
Mailing Address - Street 1:1321 WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103
Mailing Address - Country:US
Mailing Address - Phone:207-797-5577
Mailing Address - Fax:207-797-0072
Practice Address - Street 1:1321 WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103
Practice Address - Country:US
Practice Address - Phone:207-797-5577
Practice Address - Fax:207-797-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty