Provider Demographics
NPI:1740047620
Name:OAK, CHAUNA (RDH)
Entity type:Individual
Prefix:
First Name:CHAUNA
Middle Name:
Last Name:OAK
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 1:6 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3409
Mailing Address - Country:US
Mailing Address - Phone:207-651-1631
Mailing Address - Fax:
Practice Address - Street 1:6 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-2917
Practice Address - Country:US
Practice Address - Phone:207-651-1631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH4301124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist