NPI 1164241600

Laura Marie Provancha, RDH

Practitioner Dental Hygienist Dover Foxcroft, ME

Practice location

Address: 188 Summer St, Dover Foxcroft, ME 04426-1129
Phone: (207) 538-3700
Mailing address: 2741 Harrison Ave, Eureka, CA 95501-4737

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 10586 (SC)

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Registry record

NPI: 1164241600
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Oct 2024
Record last updated: 10 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.