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Individual

DALLAS R MARQUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2 GREAT FALLS PLZ STE 21, AUBURN, ME 04210-5966
(207) 330-3950
(207) 330-3955
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8950
(207) 777-8800

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
PA1298
ME

Other

Enumeration date
08/11/2011
Last updated
06/03/2022
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