Provider First Line Business Practice Location Address:
120 CENTER STREET
Provider Second Line Business Practice Location Address:
SUITE 109 AUBURN DENTURE CENTER CENTER STREET PLAZA
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-777-1149
Provider Business Practice Location Address Fax Number:
207-777-1099
Provider Enumeration Date:
01/09/2007