Organization
SMILE PATROL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHANDRA WEYMOUTH KANE RDH, PHS (OWNER)
(207) 717-8272
Entity
Organization
Contact information
Practice address
2 MATHEWS ROAD, MONSON, ME 04464-0000
(207) 997-2936
(207) 997-2936
Mailing address
PO BOX 1386, GREENVILLE, ME 04441-1386
(207) 717-8272
(207) 997-2936
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2433
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215264981
NPI - INDIVIDUAL
ME
01
—
434557000
MAINECARE
ME
Enumeration date
12/13/2010
Last updated
12/13/2010
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