Organization
T.F.I.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA A. LEAVITT R.D.H. (OWNER)
(207) 754-1176
Entity
Organization
Contact information
Practice address
795 GARFIELD RD, AUBURN, ME 04210-8941
(207) 754-1176
Mailing address
795 GARFIELD RD, AUBURN, ME 04210-8941
(207) 754-1176
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
2552
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433437000
—
ME
Enumeration date
07/22/2009
Last updated
07/22/2009
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