NPI | 1174732937 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK JOHN DIAMOND Owner 207-883-4285 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 3321) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2020-08-22 |