LAKESIDE DENTAL LLC
NPI 1891262804
Clinic/Center - Dental in Manchester, ME
Active since October 29, 2018
About Lakeside Dental Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE DENTAL LLC (NPI 1891262804) is a healthcare organization registered as a dental in Manchester, Maine and active in the NPI registry since October 2018. The organization lists Ryan Salamon, Manager, as its authorized official.
NPPES Registry Identity
NPI1891262804
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameLAKESIDE DENTAL LLC
Location Address1051 WESTERN AVEManchester, ME 04351-3403
Mailing Address60 Willow LnPortland, ME 04102-2629 · (207) 310-0842
Phone(207) 310-0842
Organization SubpartNo
Authorized OfficialRyan SalamonManager · (207) 310-0842
Enumeration DateOctober 29, 2018
✔ NPI 1891262804 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1051 WESTERN AVE, Manchester, ME 04351
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891262804, enumerated as an "organization" on October 29, 2018.
The provider is located at 1051 WESTERN AVE MANCHESTER, ME 04351 and the phone number is (207) 310-0842.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
