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NPI

3

Facility Name

Krogerfeedback

First Name

Survey

Last Name

For Fuel Points

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

Participate in Kroger customer feedback survey at https://www.krogerfeedback.com/ and get fuel points. Here is link for subway survey https://www.krogerfeedback.app/www-global-subway-com/

Physical City

Little Rock

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

Newport

Physical Zip Code

99,501

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

https://www.krogerfeedback.app/www-global-subway-com/
Created at 11/8/2019 12:26 AM by ***
Last modified at 11/8/2019 12:26 AM by ***