Individual
MICHAEL DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
76 EMERY LN, WEST GARDINER, ME 04345-3420
(207) 504-0943
Mailing address
76 EMERY LN, WEST GARDINER, ME 04345-3420
(207) 504-0943
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94400533A
—
ME
Enumeration date
05/01/2016
Last updated
05/01/2016
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