| NPI | 1073059028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY BYRD F Inancial Coordinator 207-236-4356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ME 4453) |
| Enumeration Date | 2017-01-15 |
| Last Update Date | 2017-01-15 |