Organization
KENNEBEC EYECARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER PARADIS OD (OWNER)
(207) 872-2797
Entity
Organization
Contact information
Practice address
216 MAIN ST, WATERVILLE, ME 04901-6116
(207) 872-2797
(207) 872-2793
Mailing address
216 MAIN ST, WATERVILLE, ME 04901-6116
(207) 872-2797
(207) 872-2793
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127280001
—
ME
Enumeration date
09/28/2006
Last updated
09/26/2024
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