| NPI | 1104195064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASHANT KAUSHIK Dentist 207-773-1703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ME 3770) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME 3830) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |