Provider Demographics
NPI:1275728495
Name:BLUE HILL FAMILY & COSMETIC DENTISTRY PA
Entity type:Organization
Organization Name:BLUE HILL FAMILY & COSMETIC DENTISTRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:APUNTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-374-5398
Mailing Address - Street 1:PO BOX 1658
Mailing Address - Street 2:
Mailing Address - City:BLUE HILL
Mailing Address - State:ME
Mailing Address - Zip Code:04614
Mailing Address - Country:US
Mailing Address - Phone:207-374-5398
Mailing Address - Fax:207-374-3810
Practice Address - Street 1:292 SOUTH STREET
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:ME
Practice Address - Zip Code:04614
Practice Address - Country:US
Practice Address - Phone:207-374-5398
Practice Address - Fax:207-374-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty