| NPI | 1245439652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY MARK BLACKSTONE Orthodontist 207-762-7881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ME 3027) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |