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NPI

 454,545

Facility Name

 phillipbass

First Name

 Phillip

Last Name

 http://194.156.98.210/

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

 new yark

Physical City

 new yark

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

 new yark

Physical Zip Code

 454,758

Are you currently accepting new MaineCare members?

 Yes

Are you able to accommodate children with special needs?

 No

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

  
Created at 9/25/2021 3:18 AM by ***
Last modified at 9/25/2021 3:18 AM by ***