Organization · Type 2 NPI
Lakeside Dental LLC
Dental Clinic/Center · Manchester, ME
NPI number
1891262804
Active
Practice location
1051 Western Ave
Manchester, ME 04351-3403
Mailing address
60 Willow Ln
Portland, ME 04102-2629
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Another provider at this address
About NPI 1891262804
Lakeside Dental LLC's National Provider Identifier is 1891262804, issued on Oct 29, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Manchester, ME. The record was last updated on Oct 29, 2018.