Organization
ORTHODONTIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE JAY PODHOUSER DMD ABO (DMD ABO)
(207) 772-5487
Entity
Organization
Contact information
Practice address
440 WESTERN AVE, SOUTH PORTLAND, ME 04106
(207) 772-5487
(207) 772-7553
Mailing address
440 WESTERN AVE, SOUTH PORTLAND, ME 04106
(207) 772-5487
(207) 772-7553
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
ME
122300000X
Dentist
—
NH
Other
Enumeration date
08/23/2006
Last updated
08/22/2020
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