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Individual

MR. DALE T LALONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S. CCC-A

Contact information

Practice address
260 WESTERN AVE, SOUTH PORTLAND, ME 04106-2432
(207) 828-9590
(207) 828-1049
Mailing address
260 WESTERN AVE, SOUTH PORTLAND, ME 04106-2432
(207) 828-9590
(207) 828-1049

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AP159
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1042010
AETNA
05
30006549
NH
01
367490
CIGNA
01
7303080Y0NH
ANTHEM - NH
01
MNT752
HARVARD PILGRIM
Enumeration date
02/13/2007
Last updated
07/08/2007
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