Southern Maine Pediatric Dentistry
NPI #1184814568 in South Portland, Maine
Provider Information
- NPI Number
- 1184814568
- Entity Type
- Organization
- Organization Name
- Southern Maine Pediatric Dentistry
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jul 31, 2007
- Last Updated
- Jul 31, 2007
Practice Location
- Address
- 75 JOHN ROBERTS RD
- Address 2
- SUIT 10B
- City
- South Portland
- State
- Maine
- ZIP Code
- 04106-6914
- Phone
- (207) 773-3111
Authorized Official
- Name
- DR. WHITNEY RALSTON WIGNALL, DMD
- Title
- PEDIATRIC DENTIST
- Phone
- (207) 773-3111
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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