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Maine Prosthodontics

Dentist, Prosthodontics in Portland, ME. Organization (NPI-2).

NPI number1457553182
StatusActive
Last updated in NPPESNov 6, 2013

Details

NPI
1457553182
Entity type
Organization (NPI-2)
Legal business name
Maine Prosthodontics
Organization subpart
No
Enumeration date
Jun 4, 2007
Last updated
Nov 6, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223P0700X Dentist, Prosthodontics3784MEYes
1223P0700X Dentist, Prosthodontics2624ME
1223P0700X Dentist, Prosthodontics3398ME

Practice location

1250 Forest Avenue
Portland, ME 04103

Phone 207-773-6177 · Fax 207-773-6552

Mailing address

1250 Forest Avenue
Portland, ME 04103

Phone 207-773-6177 · Fax 207-773-6552

Authorized official

Frank A Musciano
Official
2077736177

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Other Prosthodontics providers in Portland, ME

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