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Individual

BARBARA C. LAVALLEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
50 LYDIA LN, SOUTH PORTLAND, ME 04106
(207) 310-4476
Mailing address
83 NORTHERN OAKS DR, RAYMOND, ME 04071-5507
(207) 310-4476

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2837
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
136040301
ME
05
249190099
ME
Enumeration date
02/09/2007
Last updated
10/10/2018
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