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1003430711
MD PORTLAND LLC
PORTLAND, ME
NPI
1003430711
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Entity Type
Organization
Authorized Contact
BEN LAWLOR
Owner
207-307-1793
Organization Subpart ?
Yes
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2020-05-29
Last Update Date
2020-05-29
Business Address
MD PORTLAND LLC
15 MIDDLE ST # A-C2
PORTLAND, ME 04101-4881
Phone number: 207-307-1793
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Mailing Address
MD PORTLAND LLC
PO BOX 850
GRAY, ME 04039-0850
Phone number:
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