Provider Demographics
NPI:1982726592
Name:WILLIAM W DREYERDMD PA
Entity Type:Organization
Organization Name:WILLIAM W DREYERDMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:DREYER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PA
Authorized Official - Phone:207-935-3133
Mailing Address - Street 1:44 PORTLAND ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-1206
Mailing Address - Country:US
Mailing Address - Phone:207-935-3133
Mailing Address - Fax:207-935-7166
Practice Address - Street 1:44 PORTLAND ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-1206
Practice Address - Country:US
Practice Address - Phone:207-935-3133
Practice Address - Fax:207-935-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME23391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99901373Medicaid