Organization
TELEDENTALASSISTANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY CARON (FOUNDER)
(207) 432-0649
Entity
Organization
Contact information
Practice address
6 CARRIAGE WAY, SCARBOROUGH, ME 04074-9602
(207) 432-0649
Mailing address
6 CARRIAGE WAY, SCARBOROUGH, ME 04074-9602
(207) 432-0649
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3394298
DL
ME
Enumeration date
06/27/2022
Last updated
06/27/2022
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