Healthcare Provider Details

I. General information

NPI: 1922924604
Provider Name (Legal Business Name): TAMARA BRENNAN SHARP RDH, IPDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WATERBORO RD
ALFRED ME
04002-3243
US

IV. Provider business mailing address

22 JOHN CLARK RD
DAYTON ME
04005-7020
US

V. Phone/Fax

Practice location:
  • Phone: 207-494-0333
  • Fax:
Mailing address:
  • Phone: 207-590-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH2970
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: