| Southern Maine Pediatric Dentistry | |
|
75 John Roberts Rd Suit 10b South Portland ME 04106-6914 | |
| (207) 773-3111 | |
| Not Available |
| Full Name | Southern Maine Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 75 John Roberts Rd, South Portland, Maine |
| Authorized Official Name and Position | Whitney Ralston Wignall (PEDIATRIC DENTIST) |
| Authorized Official Contact | 2077733111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Maine Pediatric Dentistry 75 John Roberts Rd Suit 10b South Portland ME 04106-6914 Ph: (207) 773-3111 | Southern Maine Pediatric Dentistry 75 John Roberts Rd Suit 10b South Portland ME 04106-6914 Ph: (207) 773-3111 |
| NPI Number | 1184814568 |
|---|---|
| Provider Enumeration Date | 07/31/2007 |
| Last Update Date | 07/31/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184814568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3767 (Maine) | Primary |
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