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Individual

WESLEY IRVING DANFORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.D.H.

Contact information

Practice address
18 HIGHLAND DR, BRYANT POND, ME 04219-6831
(207) 333-2089
Mailing address
18 HIGHLAND DR, BRYANT POND, ME 04219-6831
(207) 333-2089

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3659
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
434553499
ME
Enumeration date
09/02/2009
Last updated
09/02/2009
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