Provider Demographics
NPI:1851113476
Name:ATLANTIC DENTAL HYGIENE
Entity type:Organization
Organization Name:ATLANTIC DENTAL HYGIENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT DENTAL HYGIENIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PELTOLA
Authorized Official - Suffix:
Authorized Official - Credentials:IPDH
Authorized Official - Phone:207-975-2158
Mailing Address - Street 1:103 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:ME
Mailing Address - Zip Code:04864-4254
Mailing Address - Country:US
Mailing Address - Phone:207-975-2158
Mailing Address - Fax:
Practice Address - Street 1:558 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3373
Practice Address - Country:US
Practice Address - Phone:207-975-2158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-25
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental