Roger R Gagnon

NPI #1649464983 in South Portland, Maine

Provider Information

NPI Number: 1649464983
Entity Type: Organization
Organization Name: Roger R Gagnon
Primary Specialty: Optometrist
Enumeration Date: Aug 29, 2007
Last Updated: Dec 5, 2007

Practice Location

Address: 510 MAINE MALL
City: South Portland
State: Maine
ZIP Code: 04106-3238
Phone: (207) 775-2030

Authorized Official

Name: ROGER R GAGNON, O.D.
Title: CEO
Phone: (207) 775-2030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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