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Individual

ROBERT WALSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
750 STEVENS AVE, PORTLAND, ME 04103-2623
(207) 221-4747
Mailing address
131 JOHNSON RD, PORTLAND, ME 04102-1988
(207) 774-2611

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN4948
ME
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/26/2018
Last updated
07/21/2022
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