Provider Demographics
NPI:1699713057
Name:HIRST, EDWARD J (D M D)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:HIRST
Suffix:
Gender:M
Credentials:D M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1970
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-1970
Mailing Address - Country:US
Mailing Address - Phone:207-284-5253
Mailing Address - Fax:207-282-2668
Practice Address - Street 1:275 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2432
Practice Address - Country:US
Practice Address - Phone:207-284-5253
Practice Address - Fax:207-282-2668
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME23841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice