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General NPI Number Information
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NPI Number | 1851113476
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Entity Type | Organization
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Legal Business Name | ATLANTIC DENTAL HYGIENE
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 558 MAIN ST
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City | ROCKLAND
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State | ME
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Zip | 04841-3373
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Country | US
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Telephone | 207-975-2158
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Fax |
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Provider Business Mailing Address
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Address Line | 103 PINE RIDGE DR
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City | WARREN
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State | ME
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Zip | 04864-4254
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Country | US
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Telephone | 207-975-2158
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Fax |
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Authorized Official
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Title or Position | INDEPENDENT DENTAL HYGIENIST
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Name | MELISSA PELTOLA
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Credential | IPDH
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Telephone | 207-975-2158
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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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