Organization · NPI-2

Previta Oral Health Institute LLC

Dental Hygienist · Gorham, ME

NPI number1700780806
StatusActive
Last updated in NPPESOct 5, 2026

Details

NPI
1700780806
Entity type
Organization (NPI-2)
Legal business name
Previta Oral Health Institute LLC
Organization subpart
No
Enumeration date
Oct 5, 2026
Certification date
Oct 4, 2026
Last updated
Oct 5, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
124Q00000X Dental Hygienist––Yes

Practice location

130 Main St
Gorham, ME 04038-1319

Phone 781-518-1334

Mailing address

439 Us Route 1 Ste A
York, ME 03909-1638

Phone 781-518-1334

Authorized official

Diego Barbosa Da Silva
Dental Hygienist
7815181334

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