Organization
LISBON FAMILY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNA PULKKA DMD (DENTIST)
(207) 751-9404
Entity
Organization
Contact information
Practice address
568 LISBON ST, SUITE 1, LISBON FALLS, ME 04252-1138
(207) 407-4301
Mailing address
244 VERANDA ST, UNIT 2, PORTLAND, ME 04103-5554
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4065
ME
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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