Provider Demographics
NPI:1225606064
Name:SCIOLINO, KRISTEN R (DMD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:R
Last Name:SCIOLINO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 LEE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-1626
Mailing Address - Country:US
Mailing Address - Phone:207-794-6896
Mailing Address - Fax:
Practice Address - Street 1:97 LEE RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457-1626
Practice Address - Country:US
Practice Address - Phone:207-794-6896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN48091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice