Organization
PATRIOT DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN DAVID BOYNTON D.M.D (PRESIDENT)
(207) 831-0004
Entity
Organization
Contact information
Practice address
16 MAIN ST, GRAY, ME 04039-9407
(207) 657-5440
Mailing address
16 MAIN ST, GRAY, ME 04039-9407
(207) 657-5440
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
ME
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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