| 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 |