Organization
SANFORD FAMILT DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK WAYNE JONES DMD (MEMBER)
(207) 324-1345
Entity
Organization
Contact information
Practice address
11 DAIGLE LN, SUITE A, SANFORD, ME 04073-4173
(207) 324-1345
Mailing address
11 DAIGLE LN, SUITE A, SANFORD, ME 04073-4173
(207) 324-1345
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DEN4290
ME
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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