IndividualActive
Brian Waller, DMD
NPI 1285214221 · Dentist · Bangor, ME
Provider details
- NPI number
- 1285214221
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- DEN5051 (ME)
Specialties & taxonomies
Dental Providers
Practice location
1048 Union St
Bangor, ME 04401-3016
Phone: (207) 992-2152
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1599
Bangor, ME 04402-1599
Registry dates
- Enumerated
- 2021-04-13
- Last updated
- 2023-07-26
- Certified
- 2023-07-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.