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NPI

 123,456

Facility Name

 judi bola

First Name

 Poole

Last Name

 http://45.67.230.69/

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

 na

Physical City

 na

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

 na

Physical Zip Code

 1,001

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?

 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

  
Created at 11/13/2021 1:51 AM by ***
Last modified at 11/13/2021 1:51 AM by ***