{1}
##LOC[OK]##
{1}
##LOC[OK]##
##LOC[Cancel]##
{1}
##LOC[OK]##
##LOC[Cancel]##
Turn on more accessible mode
Turn off more accessible mode
Skip Ribbon Commands
Skip to main content
Turn off Animations
Turn on Animations
It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again.
Use SHIFT+ENTER to open the menu (new window).
Health PAS-OnLine
select
English US
English UK
Enable Accessibility
Help
Sign In
or
Register
It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again.
Home
Provider Directory
MaineCare Provider Directory
NOPRS Report
Surveys
Quarterly Dental Provider Survey
OnLine Website Survey
Contact Us
Site Content
Provider Blog
Billing Instructions
Biosimilar PDL Drug List
Caseload Statistics
Companion Guides
Definition of Benefits
Direct Deposit/ Electronic Funds Transfer Payment Authorization Form
EVV Guides and Manuals
Frequently Asked Questions
Legal Notices
Maine Medicaid Policy
ME R2 DOC
Medicaid's Software Vendor, Billing Agent, & Clearing House (VBC) List
Member Benefits
Member FAQ
MIHMS Bulletins
Monthly Provider Exclusion Report
MyHealth PAS User Guides
Online User Guide
Other Publications
Pharmacy Authorization Forms
Portal Guides
Portal Tips and Tricks
Provider Enrollment
Provider Fee Schedules
Provider Forms
Provider Handbooks
Provider Newsletters
Provider Training Information
Site Assets
Site Map
Special Enrollment Tools
Style Library
Test File Instructions
Trading Partner Guides
WelcomeMessageAttachment
X.12 HIPAA Acknowledgements
SpAdmin
Announcements
Calendar
Event Calendar
Home Page Rotator
ICD-10 Announcements
Important Updates
Keep in Mind
Keep in Mind ...
MaineCare Information
Medicaid News
Member Information
News for Members
News for Providers
Notices and Announcements
Provider Announcements
Provider Calender
Provider Information
Quick Links
Site Collection Help
Site Pages
Test List
TestList
Useful Links
Dental Survey Test
Provider & Billing Agent Survey
Quarterly Dental Provider Survey
Upcoming Survey Sign-Up
Quarterly Dental Provider Survey
Manage Permissions
NPI
505,050
Facility Name
https://xaydungadong.com/projects?work_style%5B%5D=4&work_sector%5B%5D=3&work_location%5B%5D=11
First Name
https://xaydungadong.com/projects?work_style%5B%5D=4&work_sector%5B%5D=4
Last Name
https://xaydungadong.com/projects?work_style%5B%5D=4&work_sector%5B%5D=4&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_style%5B%5D=4&work_sector%5B%5D=4&work_location%5B%5D=2
Physical City
https://xaydungadong.com/projects?work_style%5B%5D=4&work_sector%5B%5D=4&work_location%5B%5D=3
Physical State (Please use state abbreviation ex: ME for Maine)
https://xaydungadong.com/projects?work_style%5B%5D=4&work_sector%5B%5D=4&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_style%5B%5D=4&work_sector%5B%5D=4&work_location%5B%5D=5
Created at 10/10/2022 5:36 AM by ***
Last modified at 10/10/2022 5:36 AM by ***
Maine.gov
|
DHHS Home
|
Site Policies
|
Language Access
|
Copyright Notice
|
Privacy Statement
|
Site Map
Download Adobe Acrobat Reader
to open and read PDF documents from this site.
Download Word
to open and read Word documents(.doc/.docx) from this site.