| NPI | 1295828069 |
|---|---|
| Former Legal Business Name | DENISE M THERIAULT DMD |
| Entity Type | Organization |
| Authorized Contact | DENISE M THERIAULT Owner 207-780-1922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: ME 3390) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |