MEDICARE: MS. GLENDA MARIE MILLIMAN RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	RDH3695	ME

General Provider Information

NPI Number	:	1518899020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GLENDA MARIE MILLIMAN RDH

Provider Business Mailing Address
First Line	:	18 BOULDER LN UNIT 18
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073-2586
Country	:	US
Telephone Number	:	603-534-1113
Fax Number	:

Provider Business Practice Location Address
First Line	:	323 MAIN ST STE 2
Second Line	:
City	:	SACO
State	:	ME
Zip	:	04072-1514
Country	:	US
Telephone Number	:	207-800-9315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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