Organization
VILLAGE SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA KAY CRANDALL (INDEPENDENT DENTAL HYGIENIST)
(207) 793-8881
Entity
Organization
Contact information
Practice address
26 MAIN ST, LIMERICK, ME 04048-3534
(207) 793-8881
Mailing address
26 MAIN ST, P.O. BOX 74, LIMERICK, ME 04048-3534
(207) 793-8881
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
IPH30
ME
124Q00000X
Dental Hygienist
LAN30
ME
124Q00000X
Dental Hygienist
PHS886
ME
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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