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NPI

 8,464,949,794,613

Facility Name

 IDN POKER

First Name

 IDN

Last Name

 Poker

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

 indonesia

Physical City

 medan

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

 Alaska

Physical Zip Code

 62,550

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?

 No

Are you able to provide services to children with intellectual disabilities such as autism?

 No

Dental License Number

 https://daftar-idn-poker.tiu.ru/  https://idn-poker.prom.ua/
Created at 6/11/2020 4:01 AM by ***
Last modified at 6/11/2020 4:01 AM by ***