Organization
MD PORTLAND LLC
Active
Parent organization
LAWLOR ENTERPRISES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAWLOR ENTERPRISES LLC
Authorized official
DR. BEN LAWLOR DDS (OWNER)
(207) 307-1793
Entity
Organization
Contact information
Practice address
15 MIDDLE ST # A-C2, PORTLAND, ME 04101-4881
(207) 307-1793
Mailing address
PO BOX 850, GRAY, ME 04039-0850
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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