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General NPI Number Information
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NPI Number | 1851877674
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Entity Type | Individual
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Provider Name | AMBER M CORRERA IPDH
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Gender | Female
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Dates
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Enumeration Date | 07/15/2018
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 276 US ROUTE 1 UNIT B
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City | YORK
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State | ME
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Zip | 03909-1629
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Country | US
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Telephone | 617-420-2338
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Fax |
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Provider Business Mailing Address
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Address Line | 22 DONICA RD
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City | YORK
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State | ME
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Zip | 03909-1619
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Country | US
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Telephone | 617-420-2338
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Fax |
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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 | 000906047
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | RDH4531
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License Number State | ME
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