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General NPI Number Information
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NPI Number | 1134985716
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Entity Type | Organization
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Legal Business Name | SMILESTORIES MAINE PA
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 765 US ROUTE 1
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City | YARMOUTH
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State | ME
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Zip | 04096-6928
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Country | US
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Telephone | 631-553-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 20 HEMLOCK DR
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City | CUMBERLAND
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State | ME
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Zip | 04021-4051
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COLLEEN AHERN
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Credential | DMD
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Telephone | 631-553-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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