Organization
DEERING CENTER DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB NICHOLS DMD (DENTIST)
(207) 408-1001
Entity
Organization
Contact information
Practice address
163 PLEASANT AVE APT 2, PORTLAND, ME 04103-3242
(207) 771-2093
Mailing address
163 PLEASANT AVE APT 2, PORTLAND, ME 04103-3242
(207) 771-2093
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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