Provider Demographics
NPI:1629387931
Name:ROSEMARIE SHELINE DDS PA
Entity Type:Organization
Organization Name:ROSEMARIE SHELINE DDS PA
Other - Org Name:MAPLE WAY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-784-2211
Mailing Address - Street 1:110 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7710
Mailing Address - Country:US
Mailing Address - Phone:207-784-2211
Mailing Address - Fax:
Practice Address - Street 1:110 CANAL ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7710
Practice Address - Country:US
Practice Address - Phone:207-784-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME41561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty