Portland Oral & Maxillofacial Surgery
LBN: Maine Coast Oral Surgery
Portland Oral & Maxillofacial Surgery is an health care organization with primary practice located at 1601 Congress St , Portland ME 04102-2102. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Pathology, Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Radiology. Dental Providers / Oral and Maxillofacial Pathology is the primary health care specialty.
Maine Coast Oral Surgery can be contacted via phone (207) 772-8055, or through Collett, Russell J via phone (207) 772-8055.
Contact Information
Primary practice address
1601 Congress St
Portland ME 04102-2102
Phone: (207) 772-8055
Fax: (207) 772-8752
Website:
Authorized official contact:
Name: Collett, Russell J Doctor of Dental Surgery (DDS)
Phone: (207) 772-8055
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | ||
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | ||
| Dental Providers / Oral and Maxillofacial Radiology | 1223X0008X |
Profile Details
| NPI number | 1952717084 |
|---|---|
| LBN Legal business name | Maine Coast Oral Surgery |
| DBA Doing business as | Portland Oral & Maxillofacial Surgery |
| Authorized official | Collett, Russell J Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 9th, 2014 |
| Last updated | Mar 17th, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952717084 | NPPES |
| Maine | Other | 1780995712 | ORAL & MAXILLOFACIAL SURGERY |
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