Organization
FORESIDE FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS HALLISSEY (OWNER)
(302) 354-0155
Entity
Organization
Contact information
Practice address
23 WALKER ST, KITTERY, ME 03904-1728
(207) 439-2310
Mailing address
23 WALKER ST, KITTERY, ME 03904-1728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4412
ME
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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