Organization
DAVID A. THERIAULT, D.M.D
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSAY HARVEY (OFFICE MANAGER)
(207) 594-8353
Entity
Organization
Contact information
Practice address
19 SUMMER ST, ROCKLAND, ME 04841-2917
(207) 594-8353
(207) 594-8306
Mailing address
19 SUMMER ST, ROCKLAND, ME 04841-2917
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3298
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037579
FEDERAL BLUE CROSS
ME
Enumeration date
04/26/2007
Last updated
08/22/2020
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