| NPI | 1891236766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY J TEGUIS Owner 207-282-5682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ME 3652) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ME 2589) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-05-16 |