Individual
STACEY LYNN BLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 WESTERN AVE, AUGUSTA, ME 04330-7241
(207) 621-6700
Mailing address
102 WESTERN AVE, AUGUSTA, ME 04330-7241
(207) 621-6700
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH2840
ME
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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