| NPI | 1881988210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID GIBBS Owner 207-878-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ME DEN3759) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-06-02 |