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General NPI Number Information
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NPI Number | 1225230048
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Entity Type | Organization
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Legal Business Name | PREVENTION PARTNERS INC
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 448 WISCASSET RD
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City | BOOTHBAY
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State | ME
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Zip | 04537-4624
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Country | US
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Telephone | 207-633-9716
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Fax | 207-633-2653
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Provider Business Mailing Address
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Address Line | 448 WISCASSET RD
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City | BOOTHBAY
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State | ME
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Zip | 04537-4624
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Country | US
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Telephone | 207-633-9716
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Fax | 207-633-2653
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LINDA M WACHOLTZ
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Credential | RDH
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Telephone | 207-633-9716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 0429
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License Number State | ME
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