Provider Demographics
NPI:1487867792
Name:MITCHELL AUSTER DMD
Entity Type:Organization
Organization Name:MITCHELL AUSTER DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-784-2142
Mailing Address - Street 1:1065 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5749
Mailing Address - Country:US
Mailing Address - Phone:207-784-2142
Mailing Address - Fax:
Practice Address - Street 1:1065 LISBON ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5749
Practice Address - Country:US
Practice Address - Phone:207-784-2142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME23281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty