Organization
CANDID MAINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD D'AVANZO DMD (OWNER)
(860) 481-7631
Entity
Organization
Contact information
Practice address
415 CONGRESS ST STE 201, PORTLAND, ME 04101-3500
(860) 481-7631
Mailing address
44 W 28TH ST FL 14, NEW YORK, NY 10001-4212
(860) 481-7631
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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