| NPI | 1962697318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH RAYMOND KENNEALLY President 207-283-1752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 2876) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |