| NPI | 1013121342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKKI M STUDLEY Practice Administrator 207-622-0861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 3692) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ME 2482) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2012-03-13 |