| NPI | 1306871405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MICHAEL MAITRE President 251-344-4571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AL 2723) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AL 4529) |
| 1223G0001X Dentist General Practice (Licence: AL 5412) | |
| 1223G0001X Dentist General Practice (Licence: AL 5689) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-07-09 |