Provider Demographics
NPI:1134905615
Name:BALANCED DENTAL HYGIENE SUITE
Entity type:Organization
Organization Name:BALANCED DENTAL HYGIENE SUITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SHAREHOLDER
Authorized Official - Prefix:
Authorized Official - First Name:KALA
Authorized Official - Middle Name:HOLBROOKE
Authorized Official - Last Name:MYERS-FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, IPDH
Authorized Official - Phone:207-542-0526
Mailing Address - Street 1:88 HOSMER POND RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-4218
Mailing Address - Country:US
Mailing Address - Phone:207-542-0526
Mailing Address - Fax:
Practice Address - Street 1:91 ELM ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1906
Practice Address - Country:US
Practice Address - Phone:207-542-0526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental