| NPI | 1427390491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK WAYNE JONES Member 207-324-1345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ME DEN4290) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2013-03-18 |