Individual
KEVIN M CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1065 LISBON ST, LEWISTON, ME 04240-5749
(207) 376-4977
(207) 376-4979
Mailing address
1065 LISBON ST, LEWISTON, ME 04240-5749
(207) 376-4977
(207) 376-4979
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3619
ME
Other
Enumeration date
10/04/2006
Last updated
02/20/2012
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