Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery | |
Dental |
261QD0000X |
| NPI Number | 1336896489 |
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| LBN Legal business name | MID MAINE ORAL SURGERY | ||||
| Authorized official | LUKE L'HEUREUX - (ORAL SURGEON) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 03/08/2022 | ||||
| Last updated | 03/25/2022 - About 4 years ago | ||||
| Identifiers |
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