Provider Demographics
NPI:1194419382
Name:LEVASSEUR DENTISTRY, LLC
Entity type:Organization
Organization Name:LEVASSEUR DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEVASSEUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-764-3040
Mailing Address - Street 1:169 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3103
Mailing Address - Country:US
Mailing Address - Phone:207-764-3040
Mailing Address - Fax:
Practice Address - Street 1:169 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3103
Practice Address - Country:US
Practice Address - Phone:207-764-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty