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General NPI Number Information
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NPI Number | 1396144002
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Entity Type | Individual
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Provider Name | DEBRA ANN DOODY IPH
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Gender | Female
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 294 RT 201 - SKOWHEGON ROAD
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City | FAIRFIELD
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State | ME
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Zip | 04937
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Country | US
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Telephone | 207-453-6171
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Fax | 207-453-6171
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Provider Business Mailing Address
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Address Line | 272 UPPER MAIN STREET
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City | FAIRFIELD
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State | ME
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Zip | 04937
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Country | US
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Telephone | 207-453-6171
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Fax | 207-453-6171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | IPH50
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License Number State | ME
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