Provider Demographics
NPI:1518398023
Name:JM DENTAL PC
Entity Type:Organization
Organization Name:JM DENTAL PC
Other - Org Name:YORK FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:MARHUE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-363-7102
Mailing Address - Street 1:433 F US ROUTE 1
Mailing Address - Street 2:SUITE 107
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909
Mailing Address - Country:US
Mailing Address - Phone:207-363-7102
Mailing Address - Fax:
Practice Address - Street 1:433 F US ROUTE 1
Practice Address - Street 2:SUITE 107
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909
Practice Address - Country:US
Practice Address - Phone:207-363-7102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN 4339122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty