| NPI | 1124125380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA GLIDDEN Owner 207-363-7270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ME 3676) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-12-16 |