Provider Demographics
NPI:1922452721
Name:MACOMER, DONA (DENTAL HYGIENIST RDH)
Entity Type:Individual
Prefix:MRS
First Name:DONA
Middle Name:
Last Name:MACOMER
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426-0426
Mailing Address - Country:US
Mailing Address - Phone:207-607-9374
Mailing Address - Fax:
Practice Address - Street 1:5 WINTER ST
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1022
Practice Address - Country:US
Practice Address - Phone:207-564-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2624124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist