Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 3537 | ME |
NPI | 1053648733 |
---|---|
Provider Name | Cara Dionne |
First Address | Topsham, ME 04086-1856 |
Second Address | Falmouth, ME 04105-1779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2009 |
Last Update Date | 20/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
434935399 | (05) | ME |