Provider Demographics
NPI:1861388134
Name:COBB-CASTONGUAY, REBECCA SUE (RDH, IPDH)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:COBB-CASTONGUAY
Suffix:
Gender:F
Credentials:RDH, IPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HOMEPLACE
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-5147
Mailing Address - Country:US
Mailing Address - Phone:207-751-1771
Mailing Address - Fax:
Practice Address - Street 1:331 MAINE ST STE 24
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3359
Practice Address - Country:US
Practice Address - Phone:207-504-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH2731124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist