Provider Demographics
NPI:1497722896
Name:FINEGOLD, JEFFREY BRUCE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:BRUCE
Last Name:FINEGOLD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2359
Mailing Address - Country:US
Mailing Address - Phone:207-772-4359
Mailing Address - Fax:207-772-4990
Practice Address - Street 1:612 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2359
Practice Address - Country:US
Practice Address - Phone:207-772-4359
Practice Address - Fax:207-772-4990
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME27931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice