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NPI 1962944645

NPI 1962944645 : LINDSEY APRIL YOUNG LD : PROSPECT, ME

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General NPI Number Information
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    NPI Number           |    1962944645
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    Entity Type          |    Individual 
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    Provider Name        |    LINDSEY APRIL YOUNG LD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/10/2016
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    Last Update Date     |    11/10/2016
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Provider Practice Location Address
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    Address Line         |    477 N SEARSPORT RD 
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    City                 |    PROSPECT
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    State                |    ME
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    Zip                  |    04981-3401
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    Country              |    US
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    Telephone            |    207-322-9988
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    477 N SEARSPORT RD 
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    City                 |    PROSPECT
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    State                |    ME
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    Zip                  |    04981-3401
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    Country              |    US
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    Telephone            |    207-322-9988
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122400000X
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    Taxonomy Name        |    Denturist
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    License Number       |    DTR5530
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    License Number State |    ME
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