NPI | 1619168655 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN M WILLIS President 207-781-2272 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: 2312) |
Enumeration Date | 2007-08-06 |
Last Update Date | 2007-08-06 |