Organization
THE OPPORTUNITY ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HAWLEY (REVENUE MANAGER)
(207) 523-5018
Entity
Organization
Contact information
Practice address
50 LYDIA LN, S PORTLAND, ME 04106-2156
(207) 874-1055
Mailing address
50 LYDIA LN, S PORTLAND, ME 04106-2156
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942328356
—
ME
Enumeration date
09/06/2018
Last updated
09/06/2018
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