Provider Demographics
NPI:1194936948
Name:WATERHOUSE, JAMES C (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:WATERHOUSE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:324 GANNETT DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3270
Mailing Address - Country:US
Mailing Address - Phone:207-253-5600
Mailing Address - Fax:
Practice Address - Street 1:324 GANNETT DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3270
Practice Address - Country:US
Practice Address - Phone:207-253-5600
Practice Address - Fax:207-253-8047
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME27181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry