Individual
REBECCA J CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
348 BUCK ST, BANGOR, ME 04401-5932
(207) 949-0860
Mailing address
348 BUCK STREET, BANGOR, ME 04401
(207) 949-0860
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
5509
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433053499
—
ME
Enumeration date
05/27/2009
Last updated
03/17/2018
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