MD Portland LLC

NPI #1003430711 in Portland, Maine

Provider Information

NPI Number: 1003430711
Entity Type: Organization
Organization Name: MD Portland LLC
Subpart: Yes (part of a larger organization)
Parent Organization: LAWLOR ENTERPRISES LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: May 29, 2020
Last Updated: May 29, 2020

Practice Location

Address: 15 MIDDLE ST # A-C2
City: Portland
State: Maine
ZIP Code: 04101-4881
Phone: (207) 307-1793

Authorized Official

Name: DR. BEN LAWLOR, DDS
Title: OWNER
Phone: (207) 307-1793

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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