Provider Demographics
NPI:1346948171
Name:POLISHED ORAL HEALTH, LLC
Entity Type:Organization
Organization Name:POLISHED ORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:IPDH
Authorized Official - Phone:207-316-6935
Mailing Address - Street 1:133 CHARETTE HILL RD
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1929
Mailing Address - Country:US
Mailing Address - Phone:207-316-6935
Mailing Address - Fax:
Practice Address - Street 1:226 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1119
Practice Address - Country:US
Practice Address - Phone:207-316-6935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty