| NPI | 1093113318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BRENT CASTON Billing Manager 207-255-0763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: ME 2212) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2024-02-07 |