Provider Demographics
NPI:1598181893
Name:LANPHER, AIMEE
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:LANPHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 FULLER RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:ME
Mailing Address - Zip Code:04419-3333
Mailing Address - Country:US
Mailing Address - Phone:207-513-1111
Mailing Address - Fax:
Practice Address - Street 1:825 FULLER RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:ME
Practice Address - Zip Code:04419-3333
Practice Address - Country:US
Practice Address - Phone:207-513-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH2776124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MERDH 2776Medicaid