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NPI

 125

Facility Name

 sadiejewell

First Name

 Sadie1234

Last Name

 https://www.tommypetrussia.com/

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

 jkuuumy

Physical City

 uk

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

 hthngnn

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?

 No

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

 Yes

Dental License Number

 242042042
Created at 1/7/2022 1:44 AM by ***
Last modified at 1/7/2022 1:44 AM by ***