| NPI | 1376878199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN TYLER WOOD Dentist 207-743-2649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME DEN2983) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2009-10-13 |