Provider Demographics
NPI:1841852084
Name:ARSENAULT, STEPHEN GEORGE (OD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:GEORGE
Last Name:ARSENAULT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2015
Mailing Address - Country:US
Mailing Address - Phone:207-729-8474
Mailing Address - Fax:207-729-8955
Practice Address - Street 1:240 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1509
Practice Address - Country:US
Practice Address - Phone:207-729-8474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT1007152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist