Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DEN4422 | ME |
N | 1223D0001X | Dental Public Health | DEN4422 | ME |
NPI | 1104205772 |
---|---|
Provider Name | Dr. Karen Jo Delaney |
First Address | Calais, ME 04619-1322 |
Second Address | Calais, ME 04619-1859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 26/10/2016 |