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NPI

 13,243

Facility Name

 KathleenShook

First Name

 Kathleen

Last Name

 Shook

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

 New York

Physical City

 USA

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

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Physical Zip Code

 10,007

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 5/31/2019 7:25 AM by ***
Last modified at 5/31/2019 7:25 AM by ***