select
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NPI

505,050

Facility Name

https://xaydungadong.com/projects?work_sector%5B%5D=5&work_location%5B%5D=11

First Name

https://xaydungadong.com/projects?work_sector%5B%5D=8

Last Name

https://xaydungadong.com/projects?work_sector%5B%5D=8&work_location%5B%5D=1

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

https://xaydungadong.com/projects?work_sector%5B%5D=8&work_location%5B%5D=2

Physical City

https://xaydungadong.com/projects?work_sector%5B%5D=8&work_location%5B%5D=3

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

https://xaydungadong.com/projects?work_sector%5B%5D=8&work_location%5B%5D=4

Physical Zip Code

180,001

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://xaydungadong.com/projects?work_sector%5B%5D=8&work_location%5B%5D=5
Created at 10/10/2022 3:54 AM by ***
Last modified at 10/10/2022 3:54 AM by ***