Provider Demographics
NPI:1760586135
Name:ORAL & MAXILLOFACIAL SURGEONS OF THE MIDCOAST
Entity Type:Organization
Organization Name:ORAL & MAXILLOFACIAL SURGEONS OF THE MIDCOAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BATTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-338-0273
Mailing Address - Street 1:189 NORTHPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915
Mailing Address - Country:US
Mailing Address - Phone:207-338-0273
Mailing Address - Fax:207-338-0275
Practice Address - Street 1:189 NORTHPORT AVE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915
Practice Address - Country:US
Practice Address - Phone:207-338-0273
Practice Address - Fax:207-338-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME23621223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty