Organization
RADIANCE FACIAL COSMETIC SURGERY & LASER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE L ROONEY (OFFICE MANAGER)
(207) 764-6337
Entity
Organization
Contact information
Practice address
181 ACADEMY ST, SUITE #1, PRESQUE ISLE, ME 04769-3178
(207) 764-6337
(207) 764-1446
Mailing address
181 ACADEMY ST, SUITE #1, PRESQUE ISLE, ME 04769-3178
(207) 764-6337
(207) 764-1446
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
36809
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132730000
—
ME
Enumeration date
06/24/2008
Last updated
09/10/2008
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