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Organization

DENTAL SPECIALISTS OF PORTLAND

Active
Parent organization
DENTAL SPECIALISTS OF YARMOUTH, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL SPECIALISTS OF YARMOUTH, LLC
Authorized official
MISS MARCIE PAULINE PHILLIPS (PRACTICE MANAGER)
(207) 879-0010
Entity
Organization

Contact information

Practice address
1355 CONGRESS ST, SUITE A, PORTLAND, ME 04102-2160
(207) 879-0010
(207) 879-0011
Mailing address
1355 CONGRESS ST, SUITE A, PORTLAND, ME 04102-2160
(207) 879-0010
(207) 879-0011

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3810
ME

Other

Enumeration date
12/27/2007
Last updated
12/27/2007
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