Organization
WESTERN MAINE DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN TYLER WOOD D.M.D. (DENTIST)
(207) 743-2649
Entity
Organization
Contact information
Practice address
193 MAIN ST, NORWAY, ME 04268-5645
(207) 743-2649
(207) 743-0432
Mailing address
193 MAIN ST, NORWAY, ME 04268-5645
(207) 743-2649
(207) 743-0432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN2983
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118930000
—
ME
Enumeration date
10/13/2009
Last updated
10/13/2009
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