Donald Leon Theriault in Portland - Periodontics
Donald Leon Theriault - NPI 1669502795
Donald Leon Theriault is a Periodontics in Portland, Maine. Donald Leon Theriault practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Donald Leon Theriault is 1669502795. The last update date is 2007-07-08.
Donald Leon Theriault's current location address is 595 Brighton Ave, Portland, Maine. You can contact this provider via phone number 2077741471. The mailing address for Donald Leon Theriault is 595 Brighton Ave, Portland, Maine. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Donald Leon Theriault |
|---|---|
| Address | 595 Brighton Ave, Portland, Maine |
| Phone Number | 2077741471 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1669502795 |
|---|---|
| Provider Enumeration Date | 2007-03-07 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 595 Brighton Ave |
|---|---|
| City | Portland |
| State | Maine (ME) |
| Post Code | 41022322 |
| Phone Number | 2077741471 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 2974 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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What is the unique 10-digit identifier code issued to Donald Leon Theriault by the Centers for Medicare & Medicaid Services?
The Donald Leon Theriault has been assigned the NPI (National Provider Identifier) 1669502795 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Donald Leon Theriault's physical address?
The Donald Leon Theriault is physically located at 595 Brighton Ave, in the city of Portland, ME, with the postal code 41022322.
What is the Donald Leon Theriault's area of specialization and corresponding taxonomy classification?
The Donald Leon Theriault's specialty field is Periodontics, and it falls under the taxonomy code 1223P0300X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1669502795 to Donald Leon Theriault?
The Centers for Medicare & Medicaid Services originally issued the 1669502795 to Donald Leon Theriault on 2007-03-07.
As of what date were the details pertaining to Donald Leon Theriault last refreshed?
The information related to the Donald Leon Theriault, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
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