Provider Demographics
NPI:1487979035
Name:FROTHINGHAM, TAMSYN YOUNG (IPDH)
Entity type:Individual
Prefix:
First Name:TAMSYN
Middle Name:YOUNG
Last Name:FROTHINGHAM
Suffix:
Gender:F
Credentials:IPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118A HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PARIS
Mailing Address - State:ME
Mailing Address - Zip Code:04289-5207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:79 ROLLER RINK RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:ME
Practice Address - Zip Code:04270-3544
Practice Address - Country:US
Practice Address - Phone:207-539-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEIPH20124Q00000X
MERDH2774124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist