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NPI

 454,646

Facility Name

 tyreeritter

First Name

 Tyree

Last Name

 https://www.gclubpremier.com/

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

 new york

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

 new york

Physical Zip Code

 53,355

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?

 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 12/23/2021 4:51 AM by ***
Last modified at 12/23/2021 4:51 AM by ***