Healthcare Provider Details
I. General information
NPI: 1700723632
Provider Name (Legal Business Name): MARANACOOK COMMUNITY DENTAL HYGIENE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
47 LEDGEWOOD DR
READFIELD ME
04355-3381
US
IV. Provider business mailing address
47 LEDGEWOOD DR
READFIELD ME
04355-3381
US
V. Phone/Fax
- Phone: 207-240-9977
- Fax:
- Phone: 207-240-9977
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 124Q00000X |
| Taxonomy | Dental Hygienist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHELSEY
LABRIE
Title or Position: OWNER
Credential: RDH, IPDH
Phone: 207-240-9977