| NPI | 1568779957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELSON HENRY Dentist 207-728-7557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ME 3474) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME 3697) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2010-09-07 |