Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | IPDH76 | ME |
NPI | 1083071401 |
---|---|
Provider Name | Christina Corbin-Price |
First Address | Buxton, ME 04093-3430 |
Second Address | Buxton, ME 04093-3430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2016 |
Last Update Date | 16/01/2016 |