Organization
MAINE PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LEE (COO)
(732) 207-1689
Entity
Organization
Contact information
Practice address
85 WESTERN AVE, SOUTH PORTLAND, ME 04106-2423
(207) 408-0479
Mailing address
290 BRIDGTON RD STE 2, WESTBROOK, ME 04092-3754
(732) 207-1689
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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