Mark Edward Grubb
Oral and Maxillofacial Pathology
37 Bower St
Bangor
, Maine 04401-4721
Mark Edward Grubb
Oral and Maxillofacial Pathology
37 Bower St
Bangor
, Maine 04401-4721
(207) 945-5353
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Mark Edward Grubb
- 91 Judson Blvd
- Bangor, ME
- Zip : 04401-2521
- Phone : (207) 945-5353
Second Address
- Mark Edward Grubb
- 37 Bower St
- Bangor, ME
- Zip : 04401-4721
- Fax : (207) 942-9525
- Phone : (207) 945-5691
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 3340 | ME |
National Provider Identifier
| NPI | 1518003094 |
|---|---|
| Provider Name | Mark Edward Grubb |
| First Address | Bangor, ME 04401-2521 |
| Second Address | Bangor, ME 04401-4721 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/01/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T93694 | (02) | ME |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.