Healthcare Provider Details

I. General information

NPI: 1073205415
Provider Name (Legal Business Name): LAUREN ENRIGHT RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 N MAIN ST
STRONG ME
04983-3005
US

IV. Provider business mailing address

177 N MAIN ST
STRONG ME
04983-3005
US

V. Phone/Fax

Practice location:
  • Phone: 207-684-3045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4491
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: