| NPI | 1063615896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE MARIE LARRABEE Practice Manager 207-929-6626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 2591) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2020-08-22 |