| NPI | 1992823009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A LEAVITT Office Manager 207-829-5937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 2568) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |