Individual
CHELSEA JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 TECHNOLOGY WAY, SCARBOROUGH, ME 04074-7654
(207) 883-4203
Mailing address
23 BURGET AVE, MEDFORD, MA 02155-5422
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DEN4777
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2018
Last updated
09/01/2020
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