| NPI | 1558249219 |
|---|---|
| Doing Business As | MAINE TINY DENTAL ELIOT LLC |
| Entity Type | Organization |
| Authorized Contact | KELLI DESOUZA Ipdh/Owner/President 207-500-1525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-21 |