Individual
MICHAEL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
276 CANCO RD, PORTLAND, ME 04103-4351
(207) 874-1025
Mailing address
276 CANCO RD, PORTLAND, ME 04103-4351
(207) 874-1025
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3523
ME
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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