Healthcare Provider Details

I. General information

NPI: 1184552945
Provider Name (Legal Business Name): CATHOLIC CHARITIES MAINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 CONGRESS AVE
BATH ME
04530-1531
US

IV. Provider business mailing address

PO BOX 10660
PORTLAND ME
04104-6060
US

V. Phone/Fax

Practice location:
  • Phone: 207-443-9721
  • Fax: 207-443-9722
Mailing address:
  • Phone: 207-781-8550
  • Fax: 207-781-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA J GILBERTI-PEKINS
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 207-239-2975