Healthcare Provider Details

I. General information

NPI: 1255137915
Provider Name (Legal Business Name): DENTURE DYNAMICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HARRINGTON RD
WALPOLE ME
04573-3208
US

IV. Provider business mailing address

40 HARRINGTON RD
WALPOLE ME
04573-3208
US

V. Phone/Fax

Practice location:
  • Phone: 207-563-3368
  • Fax:
Mailing address:
  • Phone: 207-563-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN E HIGGINS
Title or Position: OWNER/DENTURIST
Credential: LD
Phone: 207-563-3368