Fryeburg Family Dental

NPI #1538541727 in Fryeburg, Maine

Provider Information

NPI Number: 1538541727
Entity Type: Organization
Organization Name: Fryeburg Family Dental
Primary Specialty: Dental Hygienist
Enumeration Date: Jun 24, 2015
Last Updated: Jun 24, 2015

Practice Location

Address: 19 PORTLAND ST
City: Fryeburg
State: Maine
ZIP Code: 04037-1205
Phone: (207) 256-7606

Authorized Official

Name: MRS. BERNADETTE KOZAK, IPDH
Title: OWNER/OPERATOR
Phone: (207) 256-7606

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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