Organization
PORTLAND NORTH DENTAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ANTHONY DERICE D.M.D. (PRESIDENT)
(207) 878-3100
Entity
Organization
Contact information
Practice address
9 SANBORN ST, PORTLAND, ME 04103-2107
(207) 878-3100
Mailing address
9 SANBORN ST, PORTLAND, ME 04103-2107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2652
ME
Other
Enumeration date
10/24/2006
Last updated
08/22/2020
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