Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DTR5531 | ME |
NPI | 1326581703 |
---|---|
Provider Name | Linda Laurette Souliere |
First Address | Center Ossipee, NH 03814-6716 |
Second Address | Cornish, ME 04020-3138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2016 |
Last Update Date | 02/12/2016 |