Provider Demographics
NPI:1609838200
Name:CUMMINGS, PETER CLIFTON (DMD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:CLIFTON
Last Name:CUMMINGS
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 1:201 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1715
Mailing Address - Country:US
Mailing Address - Phone:207-667-8778
Mailing Address - Fax:207-667-8778
Practice Address - Street 1:201 HIGH ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1715
Practice Address - Country:US
Practice Address - Phone:207-667-8778
Practice Address - Fax:207-667-8778
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME35061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice