Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DEN4796 | ME |
NPI | 1285258715 |
---|---|
Provider Name | Daniel Duarte |
First Address | Bingham, ME 04920-4015 |
Second Address | Bingham, ME 04920-4015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2020 |
Last Update Date | 01/06/2020 |