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Individual

PAUL L AUCLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2959
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
2623
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007450055
AETNA
ME
01
036983
ANTHEM
ME
01
2323308
AETNA USHC
ME
05
3031852
NH
05
99002299
ME
01
M148551
CIGNA
ME
01
U73557
HPHC
ME
Enumeration date
11/15/2006
Last updated
07/28/2009
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