Organization
ROOSEVELT DENTAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE KIM DDS (OWNER)
(207) 894-5580
Entity
Organization
Contact information
Practice address
840 ROOSEVELT TRL, WINDHAM, ME 04062-5375
(207) 894-5580
(207) 894-5590
Mailing address
840 ROOSEVELT TRL, WINDHAM, ME 04062-5375
(207) 894-5580
(207) 894-5590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4101
ME
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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