Healthcare Provider Details

I. General information

NPI: 1598181893
Provider Name (Legal Business Name): AIMEE LANPHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 03/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FULLER RD
CARMEL ME
04419-3333
US

IV. Provider business mailing address

825 FULLER RD
CARMEL ME
04419-3333
US

V. Phone/Fax

Practice location:
  • Phone: 207-513-1111
  • Fax:
Mailing address:
  • Phone: 207-513-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH2776
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: