Organization
TOOTH FAIRIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY MARGARET MAROON RDH (DENTAL HYGIENIST)
(207) 998-3500
Entity
Organization
Contact information
Practice address
12 LAFRINEA LN, POLAND, ME 04274-6158
(207) 998-3500
Mailing address
12 LAFRINEA LN, POLAND, ME 04274-6158
(207) 998-3500
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
RDH2546
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188720000
MAINE CARE
ME
Enumeration date
07/31/2009
Last updated
07/31/2009
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