Individual
MRS. KELLY J MCAVOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
104 NORTH RD, PATTEN, ME 04765-3117
(207) 528-2081
Mailing address
104 NORTH RD, PATTEN, ME 04765-3117
(207) 528-2081
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1074
ME
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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