Individual
DR. MATTIE PARADISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
190 PARK AVE, PORTLAND, ME 04102-2910
(207) 874-1028
Mailing address
324 SHORE RD, OGUNQUIT, ME 03907-3902
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN4626
ME
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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