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NPI

123

Facility Name

triciapena

First Name

triciapena

Last Name

https://pafikotaboalemo.org

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

uk

Physical City

uk

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

uk

Physical Zip Code

10,001

Are you currently accepting new MaineCare members?

Yes

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

1023654789
Created at 12/21/2024 12:19 AM by ***
Last modified at 12/21/2024 12:19 AM by ***