Provider Demographics
NPI:1649426404
Name:3RD GENERATION DENTISTRY, PC
Entity type:Organization
Organization Name:3RD GENERATION DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:TRENTALANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-985-9857
Mailing Address - Street 1:1389 PORTLAND RD
Mailing Address - Street 2:TRENTALANGE FAMILY DENTISTRY
Mailing Address - City:ARUNDEL
Mailing Address - State:ME
Mailing Address - Zip Code:04046
Mailing Address - Country:US
Mailing Address - Phone:207-985-9857
Mailing Address - Fax:207-985-2042
Practice Address - Street 1:1389 PORTLAND RD
Practice Address - Street 2:TRENTALANGE FAMILY DENTISTRY
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046
Practice Address - Country:US
Practice Address - Phone:207-985-9857
Practice Address - Fax:207-985-2042
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:3RD GENERATION DENTISTRY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3721122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty