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NPI

88,999

Facility Name

Keputusan

First Name

Kepu

Last Name

tusan

Physical Street Address -- NOTE:  Please return to complete this Survey separately for each physical service location where you provide dental services.

Allen

Physical City

florida

Physical State (Please use state abbreviation ex: ME for Maine)

https://68.183.185.101

Physical Zip Code

10,001

Are you currently accepting new MaineCare members?

Yes

Are you able to accommodate children with special needs?

Yes

Are you able to serve children with mobility issues such as wheelchair ramps and wider doorways?

Yes

Are you able to provide services to children with complex health needs such as sedation?

Yes

Are you able to provide services to children with intellectual disabilities such as autism?

Yes

Dental License Number

9959848594499
Created at 12/29/2021 1:17 AM by ***
Last modified at 12/29/2021 1:17 AM by ***