Organization
MINT PREVENTATIVE DENTAL SPA CORNISH PLLC
Active
Other names
Fryeburg Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DAVIS IPDH (OWNER)
(603) 682-3295
Entity
Organization
Contact information
Practice address
19 PORTLAND ST STE 107, FRYEBURG, ME 04037-1294
(207) 810-6019
(570) 218-7857
Mailing address
12 SULLIVAN ST STE 107, BERWICK, ME 03901-2925
(207) 810-6019
(570) 218-7857
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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