| Gorham Village Dental Llc | |
|
77 South St Gorham ME 04038-1715 | |
| (207) 642-4300 | |
| Not Available |
| Full Name | Gorham Village Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 77 South St, Gorham, Maine |
| Authorized Official Name and Position | Cory Murray (CO-OWNER) |
| Authorized Official Contact | 2076424300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gorham Village Dental Llc 77 South St Gorham ME 04038-1715 Ph: (207) 642-4300 | Gorham Village Dental Llc 77 South St Gorham ME 04038-1715 Ph: (207) 642-4300 |
| NPI Number | 1174184253 |
|---|---|
| Provider Enumeration Date | 06/27/2019 |
| Last Update Date | 06/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174184253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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