Healthcare Provider Details

I. General information

NPI: 1710869409
Provider Name (Legal Business Name): MAINE EMERGENCY DENTIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 WATER ST
SACO ME
04072-5119
US

IV. Provider business mailing address

23 WATER ST
SACO ME
04072-5119
US

V. Phone/Fax

Practice location:
  • Phone: 207-408-6001
  • Fax:
Mailing address:
  • Phone: 207-910-2646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. GRACE HARRIMAN
Title or Position: DENTIST
Credential: DDS
Phone: 917-407-8034