Provider Demographics
NPI:1306070065
Name:BELLMORE, ABBY MAE (RDH)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:MAE
Last Name:BELLMORE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 ATLANTIC HWY
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:ME
Mailing Address - Zip Code:04864-4316
Mailing Address - Country:US
Mailing Address - Phone:207-691-1298
Mailing Address - Fax:
Practice Address - Street 1:1060 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-3801
Practice Address - Country:US
Practice Address - Phone:207-594-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH3193124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist