Organization
MAINE DENTAL BOUTIQUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY FICHTHORN (OWNER)
(207) 930-0833
Entity
Organization
Contact information
Practice address
16 COMMERCE PLZ STE 1A, WINTHROP, ME 04364-1562
(207) 930-0833
Mailing address
16 COMMERCE PLZ STE 1A, WINTHROP, ME 04364-1562
(207) 930-0833
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH4109
ME
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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