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General NPI Number Information
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NPI Number | 1700780806
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Entity Type | Organization
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Legal Business Name | PREVITA ORAL HEALTH INSTITUTE LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 130 MAIN ST
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City | GORHAM
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State | ME
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Zip | 04038-1319
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Country | US
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Telephone | 781-518-1334
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Fax |
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Provider Business Mailing Address
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Address Line | 439 US ROUTE 1 STE A
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City | YORK
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State | ME
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Zip | 03909-1638
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Country | US
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Telephone | 781-518-1334
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Fax |
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Authorized Official
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Title or Position | DENTAL HYGIENIST
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Name | DIEGO BARBOSA DA SILVA
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Credential | RDH, IPDH
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Telephone | 781-518-1334
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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 |
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License Number State | NULL
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