=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043639271
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALESHIA FIGGINS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2014
-----------------------------------------------------
Last Update Date | 04/15/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1460 HAMMOND ST CHAPEL HILL COMPLEX
-----------------------------------------------------
City | BANGOR
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04401-5790
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-262-5760
-----------------------------------------------------
Fax | 207-262-5765
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 40 KATHRYN LN
-----------------------------------------------------
City | BANGOR
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04401-5898
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | IPH69
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------