Provider Demographics
NPI:1730102138
Name:HAMPDEN FAMILY DENTISTRY, P.A.
Entity Type:Organization
Organization Name:HAMPDEN FAMILY DENTISTRY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:CUTRI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-862-2600
Mailing Address - Street 1:27 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1422
Mailing Address - Country:US
Mailing Address - Phone:207-862-2600
Mailing Address - Fax:207-862-2602
Practice Address - Street 1:27 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444-1422
Practice Address - Country:US
Practice Address - Phone:207-862-2600
Practice Address - Fax:207-862-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty