Individual
MISS ALYSSA MARION BIGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, BSDH
Contact information
Practice address
94 WASHINGTON AVE, PORTLAND, ME 04101-2630
(207) 808-9498
Mailing address
146 W GRAND AVE APT 77, OLD ORCHARD BEACH, ME 04064-3128
(978) 888-3885
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
RDH4435
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992391536
—
ME
Enumeration date
08/11/2022
Last updated
08/11/2022
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