Provider Demographics
NPI:1689759227
Name:CANGEMI, MICHAEL H (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:CANGEMI
Suffix:
Gender:M
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:PO BOX 1599
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-1599
Mailing Address - Country:US
Mailing Address - Phone:207-945-5247
Mailing Address - Fax:207-947-0435
Practice Address - Street 1:1048 UNION ST
Practice Address - Street 2:PENOBSCOT COMMUNITY HEALTH CENTER
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-8600
Practice Address - Country:US
Practice Address - Phone:207-992-2152
Practice Address - Fax:207-992-2154
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME37941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice