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Individual

MR. PATRICK D ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LD

Contact information

Practice address
12 STILLWATER AVE, BANGOR, ME 04401-3984
(207) 941-6550
Mailing address
12 STILLWATER AVE, BANGOR, ME 04401-3984
(207) 941-6550

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
5512
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
433405199
ME
Enumeration date
05/26/2009
Last updated
05/26/2009
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