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Organization
CORNISH DENTURE CENTER, LLC
Active
Organization
CORNISH DENTURE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA LAURETTE SOULIERE LD (OWNER/OPERATOR)
(207) 625-9227
Entity
Organization
Contact information
Practice address
202 MAPLE ST UNIT C, CORNISH, ME 04020-3138
(207) 625-9227
Mailing address
202 MAPLE ST UNIT C, CORNISH, ME 04020-3138
(207) 625-9227
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
DTR5531
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DTR5531
122400000X
ME
Enumeration date
11/18/2016
Last updated
11/18/2016
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