Organization
GANNETT DRIVE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GAGNON DMD (OWNER)
(603) 387-5658
Entity
Organization
Contact information
Practice address
324 GANNETT DR STE 500, SOUTH PORTLAND, ME 04106-3361
(207) 253-5600
Mailing address
10 SUSAN AVE, SCARBOROUGH, ME 04074-9726
(603) 387-5658
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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