| NPI | 1053645622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE EVAN LEVY Owner 207-782-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: ME 3325) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |