Provider Demographics
NPI:1457742488
Name:GAETH, ALISON G (RDH)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:G
Last Name:GAETH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-4683
Mailing Address - Country:US
Mailing Address - Phone:207-563-8668
Mailing Address - Fax:866-336-7756
Practice Address - Street 1:748 MAIN ST
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4683
Practice Address - Country:US
Practice Address - Phone:207-563-8668
Practice Address - Fax:866-336-7756
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH3900124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist