Individual
MS. SUSANNE J LAVALLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
45 GREENWOOD TER, WINTHROP, ME 04364-1505
(207) 377-7003
Mailing address
PO BOX 275, WINTHROP, ME 04364-0275
(207) 377-7003
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH2362
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431944500
—
ME
Enumeration date
05/20/2009
Last updated
02/16/2016
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