Provider Demographics
NPI:1568886067
Name:SASSEVILLE HEALTHY SMILE DENTAL HYGIENE & WELLNESS
Entity Type:Organization
Organization Name:SASSEVILLE HEALTHY SMILE DENTAL HYGIENE & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA-MARE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SASSEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:IPH
Authorized Official - Phone:207-241-0667
Mailing Address - Street 1:137 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5627
Mailing Address - Country:US
Mailing Address - Phone:207-241-0667
Mailing Address - Fax:207-241-0676
Practice Address - Street 1:137 EAST AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5627
Practice Address - Country:US
Practice Address - Phone:207-241-0667
Practice Address - Fax:207-241-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty