Healthcare Provider Details

I. General information

NPI: 1558509489
Provider Name (Legal Business Name): TOOTH PROTECTORS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 01/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

858 RT 106
LEEDS ME
04263
US

IV. Provider business mailing address

P. O BOX 1108
SCARBOROUGH ME
04070
US

V. Phone/Fax

Practice location:
  • Phone: 207-689-5897
  • Fax: 207-513-1197
Mailing address:
  • Phone: 207-689-5897
  • Fax: 207-513-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number3572
License Number StateME

VIII. Authorized Official

Name: MS. SABRINA TOYE
Title or Position: EXECUTIVE DIRECTOR
Credential: RDH
Phone: 207-689-5897