Provider Demographics
NPI:1447827852
Name:LABONTE, CHRISTIAN DAVID (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:DAVID
Last Name:LABONTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5221
Mailing Address - Country:US
Mailing Address - Phone:207-783-8263
Mailing Address - Fax:
Practice Address - Street 1:440 NARRAGANSETT TRL
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093-6505
Practice Address - Country:US
Practice Address - Phone:207-929-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN48901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty