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4 Commons Ave Ste 2 Windham ME 04062-5554 | |
| (207) 893-2001 | |
| (207) 893-2006 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4 Commons Ave Ste 2, Windham, Maine |
| Authorized Official Name and Position | Richard M Intiso (DENTIST) |
| Authorized Official Contact | 2078932001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4 Commons Ave Ste 2 Windham ME 04062-5554 Ph: (207) 893-2001 | 4 Commons Ave Ste 2 Windham ME 04062-5554 Ph: (207) 893-2001 |
| NPI Number | 1417074733 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417074733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DENTAL 3564 (Maine) | Primary |
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