select
Online Help Help

Manage PermissionsManage Permissions

NPI

100,000

Facility Name

https://thaihaclinic.webflow.io/

First Name

https://infogram.com/dia-chi-kham-phu-khoa-tot-va-uy-tin-nhat-o-dau-ha-noi-1h7v4pq510dj6k0

Last Name

https://infogram.com/nen-di-kham-nam-khoa-o-dau-tot-dia-chi-phong-kham-nam-khoa-uy-tin-tai-ha-noi-1hnq41je9d5p43z

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

https://infogram.com/chi-phi-cat-bao-quy-dau-het-bao-nhieu-tien-hien-nay-1hxj48jzgzq52vg

Physical City

https://infogram.com/nen-pha-thai-o-dau-ha-noi-dia-chi-phong-kham-pha-thai-an-toan-1hxj48jdnkzq2vg

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

https://infogram.com/chi-phi-pha-thai-hien-nay-la-bao-nhieu-1hxj48jrnxrq2vg

Physical Zip Code

100,000

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?

No

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

 
Created at 1/8/2020 1:20 AM by ***
Last modified at 1/8/2020 1:20 AM by ***