| NPI | 1871148296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI LEWIS Orthodontist 207-319-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2023-02-13 |