Provider Demographics
NPI:1538325568
Name:NADEAU ALDILAIMI, DENISE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:A
Last Name:NADEAU ALDILAIMI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SHUMAN AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7751
Mailing Address - Country:US
Mailing Address - Phone:207-621-2904
Mailing Address - Fax:207-623-0396
Practice Address - Street 1:8 SHUMAN AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7751
Practice Address - Country:US
Practice Address - Phone:207-621-2904
Practice Address - Fax:207-623-0396
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3697122300000X
MEDEN36971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentist