Provider Demographics
NPI:1174977730
Name:ALVAREZ, JILLIAN PAIGE (RDH)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:PAIGE
Last Name:ALVAREZ
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 1:8 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1117
Mailing Address - Country:US
Mailing Address - Phone:207-615-8684
Mailing Address - Fax:
Practice Address - Street 1:6 FUNDY RD STE 200
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1780
Practice Address - Country:US
Practice Address - Phone:207-781-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4058124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist