| NPI | 1851836001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD JAMES WOODFORD Owner 207-945-6324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: ME DEN4336) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2016-12-27 |