Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | RDH3092 | ME |
NPI | 1023662764 |
---|---|
Provider Name | Sheila Ciappetta |
First Address | Patten, ME 04765-3007 |
Second Address | Patten, ME 04765-3007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2019 |
Last Update Date | 31/07/2019 |