| Md Portland Llc | |
|
15 Middle St # A-c2 Portland ME 04101-4881 | |
| (207) 307-1793 | |
| Not Available |
| Full Name | Md Portland Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15 Middle St # A-c2, Portland, Maine |
| Authorized Official Name and Position | Ben Lawlor (OWNER) |
| Authorized Official Contact | 2073071793 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Portland Llc Po Box 850 Gray ME 04039-0850 Ph: () - | Md Portland Llc 15 Middle St # A-c2 Portland ME 04101-4881 Ph: (207) 307-1793 |
| NPI Number | 1003430711 |
|---|---|
| Provider Enumeration Date | 05/29/2020 |
| Last Update Date | 05/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003430711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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