Organization
SUNRISE SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANA T INGALLS IPDH (INDEPENDENT DENTAL HYGIENIST)
(207) 259-1129
Entity
Organization
Contact information
Practice address
1166 PORT ROAD, MACHIASPORT, ME 04655
(207) 259-1129
Mailing address
PO BOX 34, MACHIASPORT, ME 04655-0034
(207) 259-1129
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
IPH72
ME
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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