| NPI | 1356425763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ANTHONY DERICE President 207-878-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 2652) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |