Individual
DR. PETER RENE THEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD DR MED DENT
Contact information
Practice address
254 WESTERN AVENUE, SOUTH PORTLAND, ME 04106
(207) 774-5527
(207) 780-1188
Mailing address
19 VAILL POINT ROAD, YARMOUTH, ME 04096
(207) 846-3281
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3628
ME
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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