Skip Ribbon Commands
Skip to main content

Health PAS-OnLine

select
Accessibility Enable Accessibility
Online Help Help

Manage PermissionsManage Permissions

NPI

 6,346,446

Facility Name

 Ty

First Name

 tygipson

Last Name

 https://www.smithersofstamford.com/gifts.html

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

 456,789

Are you currently accepting new MaineCare members?

 No

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?

 Yes

Dental License Number

  
Created at 11/24/2021 3:20 AM by ***
Last modified at 11/24/2021 3:20 AM by ***