Provider Demographics
NPI:1427844349
Name:CAPITAL CITY SMILES & WELLNESS LLC
Entity type:Organization
Organization Name:CAPITAL CITY SMILES & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEMPSEY
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:207-522-9749
Mailing Address - Street 1:47 PINE HILL DR
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2080
Mailing Address - Country:US
Mailing Address - Phone:207-522-9749
Mailing Address - Fax:
Practice Address - Street 1:11 MIDDLE ST # 1
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5210
Practice Address - Country:US
Practice Address - Phone:207-522-9749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental