Individual
MRS. NICOLE ANNE HASENFUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
169 WATER ST, AUGUSTA, ME 04330-4607
(207) 623-8122
Mailing address
169 WATER ST, AUGUSTA, ME 04330-4607
(207) 623-8122
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4370
ME
Other
Enumeration date
06/02/2014
Last updated
12/02/2015
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