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General NPI Number Information
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NPI Number | 1588589774
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Entity Type | Organization
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Legal Business Name | L BOULET LLC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 148 SABATTUS RD STE 4
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City | SABATTUS
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State | ME
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Zip | 04280-4021
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Country | US
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Telephone | 207-240-6662
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Fax |
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Provider Business Mailing Address
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Address Line | 17 MATOBIAN AVE
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City | LEWISTON
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State | ME
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Zip | 04240-2229
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Country | US
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Telephone | 207-240-6662
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Fax |
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Authorized Official
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Title or Position | DENTAL HYGIENIST
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Name | MRS. LISA BOULET
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Credential | RDH, IPDH
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Telephone | 207-240-6662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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