Most Relevant Information
Provider Data
| NPI Number: | 1003041609 |
| Provider Name: | SHERRY M BODGE LD |
| Entity Type: | Individual |
| Taxonomy Code: | 122400000X |
| Specialty: | Denturist |
| License Number: | 5054 |
Most Important Dates
| Enumeration Date: | 05/27/2009 |
| Last Updated: | 05/27/2009 |
Provider Practice Location
12 STILLWATER AVE
BANGOR
ME
044013984
Practice Location Phone/Fax
| Phone: | 2079416550 |
| Fax: |
Provider Mailing Location
12 STILLWATER AVE
BANGOR
ME
044013984
Provider Mailing Phone/Fax
| Phone: | 2079416550 |
| Fax: |