| NPI | 1467225466 |
|---|---|
| Doing Business As | JETPORT DENTURE CENTER |
| Entity Type | Organization |
| Authorized Contact | ASHLEY D SOUCY Owner 207-794-5322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2025-02-05 |