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Organization

ST JOHN VALLEY DENTAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NELSON HENRY DMD (DENTIST)
(207) 728-7557
Entity
Organization

Contact information

Practice address
309 SAINT THOMAS ST, SUITE 103, MADAWASKA, ME 04756-1278
(207) 728-7557
(207) 728-7558
Mailing address
309 SAINT THOMAS ST, SUITE 103, MADAWASKA, ME 04756-1278
(207) 728-7557
(207) 728-7558

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3474
ME
122300000X
Dentist
3697
ME

Other

Enumeration date
09/07/2010
Last updated
09/07/2010
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