Individual
DR. JOHN A KIVUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
324 GANNETT DR, SUITE 500, SOUTH PORTLAND, ME 04106-3270
(207) 253-5600
(207) 253-8047
Mailing address
324 GANNETT DR, SUITE 500, SOUTH PORTLAND, ME 04106-3270
(207) 253-5600
(207) 253-8047
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2776
ME
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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