Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | 3056 | ME |
Y | 124Q00000X | Dental Hygienist | IPH37 | ME |
NPI | 1053617258 |
---|---|
Provider Name | Mrs. Kala Holbrooke Myers-French |
First Address | Camden, ME 04843-4218 |
Second Address | Camden, ME 04843-4218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2011 |
Last Update Date | 04/02/2011 |