Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DTR5534 | ME |
NPI | 1942744289 |
---|---|
Provider Name | Mrs. Lyndsay Wood |
First Address | Standish, ME 04084 |
Second Address | Standish, ME 04084 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2016 |
Last Update Date | 06/12/2016 |