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1

Facility Name

 https://ecoffeemoments.net/ar/%D8%B4%D8%A7%D9%8A-%D8%AF%D9%8A%D9%84%D9%85%D8%A7-dilmah-tea/brand-1153065902

First Name

 https://ecoffeemoments.net/en/Torani/brand-1328219811

Last Name

https://ecoffeemoments.net/en/molinari-rosso-coffee/p1157445670

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

 https://ecoffeemoments.net/ar/ايس-تي/p862097586

Physical City

 https://ecoffeemoments.net/ar/blog/موهيتو/a-1072951134

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

https://sites.google.com/view/ecoffeemoments/dilmah

Physical Zip Code

2,325

Are you currently accepting new MaineCare members?

No

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?

No

Dental License Number

ايس تي  https://ecoffeemoments.net/ar/ايس-تي/p862097586
Created at 7/24/2024 11:55 AM by ***
Last modified at 7/24/2024 11:55 AM by ***