Provider Demographics
NPI:1568785798
Name:NADEAU, MARK EDMUND (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDMUND
Last Name:NADEAU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:63 PORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6669
Mailing Address - Country:US
Mailing Address - Phone:207-985-8999
Mailing Address - Fax:207-985-8965
Practice Address - Street 1:63 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6669
Practice Address - Country:US
Practice Address - Phone:207-985-8999
Practice Address - Fax:207-985-8965
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME35901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics