NPI 1003336702

Jacob Fillebrown, DMD

Practitioner General Practice Dentistry South Portland, ME

Practice location

Address: 324 Gannett Dr STE 500, South Portland, ME 04106-3361
Phone: (207) 253-5600

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence DEN4562 (ME)

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Registry record

NPI: 1003336702
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2017
Record last updated: 23 Jun 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.