Provider Demographics
NPI:1215467436
Name:DUMONT, JOSEPH REGINALD (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:REGINALD
Last Name:DUMONT
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 1:98 SILVER ST
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5935
Mailing Address - Country:US
Mailing Address - Phone:207-873-2073
Mailing Address - Fax:
Practice Address - Street 1:98 SILVER ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5935
Practice Address - Country:US
Practice Address - Phone:207-873-2073
Practice Address - Fax:207-873-2073
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN45801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice