Provider Demographics
NPI:1154396810
Name:GOLDEY, ALLEN SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:SCOTT
Last Name:GOLDEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LONE INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8544
Mailing Address - Country:US
Mailing Address - Phone:207-622-1919
Mailing Address - Fax:
Practice Address - Street 1:7 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:ME
Practice Address - Zip Code:04910-6501
Practice Address - Country:US
Practice Address - Phone:207-437-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME37001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice