Individual
STACY L WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
686 BRIGHTON AVE, PORTLAND, ME 04102-1012
(207) 772-8112
Mailing address
80 WEST LN, ARUNDEL, ME 04046-8142
(207) 229-2936
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH2961
ME
Other
Enumeration date
12/11/2021
Last updated
12/11/2021
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