Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 3170 | ME |
NPI | 1093823841 |
---|---|
Provider Name | Dr. Michelle L Mazur-Kary |
First Address | Auburn, ME 04210 |
Second Address | Auburn, ME 04210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |