Individual
MRS. THERESA MARIE BLAKE-IRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
93 MAIN ST, WATERVILLE, ME 04901-6636
(207) 872-8891
Mailing address
93 MAIN ST, WATERVILLE, ME 04901-6636
(207) 872-8891
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3040
ME
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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