Bodge, Sherry M

Bodge, Sherry M is an individual health care provider with primary practice located at 12 Stillwater Ave , Bangor ME 04401-3984. She recently has only one registered license in Dental Providers / Denturist, which is considered as her primary health care specialty. Bodge, Sherry M can be contacted via phone (207) 941-6550.

Contact Information

Primary practice address
12 Stillwater Ave Bangor ME 04401-3984
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Denturist 122400000X 5054 Maine

Profile Details

NPI number 1003041609
LBN Legal business name Bodge, Sherry M
Credentials LD
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2009
Last updated May 27th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003041609 NPPES
Maine MEDICAID 432235099

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