Individual
ELIJAH LEVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
25 STONE ST, AUGUSTA, ME 04330-6114
(207) 622-9210
Mailing address
17 SPRING ST APT 1, AUGUSTA, ME 04330-5122
(207) 712-9779
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN5038
ME
Other
Enumeration date
04/16/2022
Last updated
11/17/2023
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