Audrey Stack is a Dentist in Portland, Maine. Audrey Stack practices all healthcare services and medical treatments related to Dentist. The NPI Number for Audrey Stack is 1134287915. The last update date is 2007-07-08.
Audrey Stack's current location address is 276 Canco Rd, Portland, Maine. You can contact this provider via phone number 2078741025. The mailing address for Audrey Stack is 276 Canco Rd, Portland, Maine. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Audrey Stack |
|---|---|
| Address | 276 Canco Rd, Portland, Maine |
| Phone Number | 2078741025 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1134287915 |
|---|---|
| Provider Enumeration Date | 2006-12-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 276 Canco Rd |
|---|---|
| City | Portland |
| State | Maine (ME) |
| Post Code | 41034351 |
| Phone Number | 2078741025 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 3585 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 295140099 | ME | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Audrey Stack by the Centers for Medicare & Medicaid Services?
The Audrey Stack has been issued the NPI (National Provider Identifier) 1134287915, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Audrey Stack's facilities are geographically located?
The facilities of Audrey Stack are physically situated at the following location: 276 Canco Rd, Portland, ME, 41034351.
What is Audrey Stack's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Audrey Stack is Dentist, and the taxonomy code that classifies this field of practice is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1134287915 to Audrey Stack?
The Centers for Medicare & Medicaid Services originally issued the 1134287915 to Audrey Stack on 2006-12-05.
As of what date were the Audrey Stack's details last updated?
The information pertaining to the Audrey Stack, including its address, specialty, and other details, was most recently updated on 2007-07-08.