Organization
DUCOR DENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN DAVID GIBBS D.D.S. (OWNER)
(207) 878-8181
Entity
Organization
Contact information
Practice address
395A BRIDGTON RD, WESTBROOK, ME 04092-3733
(207) 878-8181
Mailing address
395A BRIDGTON RD, WESTBROOK, ME 04092-3733
(207) 878-8181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN3759
ME
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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