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Individual

MS. MARY BARTLETT REMINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED DENTAL HY

Contact information

Practice address
20 PORTLAND STREET, PORTLAND, ME 04101-2912
(207) 874-8450
Mailing address
20 PORTLAND STREET, HEALTHCARE FOR THE HOMELESS DENTAL CLINIC, PORTLAND, ME 04101-2912
(207) 874-8983

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
00468
NH
124Q00000X
Dental Hygienist
Primary
1082
ME
124Q00000X
Dental Hygienist
DH3854
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432757599
ME
Enumeration date
06/02/2008
Last updated
06/02/2008
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