| NPI | 1053485524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MAGNUSON Orthodontist 506-924-9860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA 3458) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA 7628) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA 7718) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |