| NPI | 1316474802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL C FACKRELL Endodontist 207-879-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ME 4291) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2017-05-16 |