select
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NPI

546

Facility Name

basilbabb

First Name

Basil

Last Name

https://pharmacyonline.help/

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

new yeark

Physical City

new yeark

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

carlifonia

Physical Zip Code

10,001

Are you currently accepting new MaineCare members?

No

Are you able to accommodate children with special needs?

No

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?

No

Dental License Number

 
Created at 12/31/2021 5:12 AM by ***
Last modified at 12/31/2021 5:12 AM by ***