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General NPI Number Information
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NPI Number | 1043018831
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Entity Type | Organization
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Legal Business Name | KATAHDIN SMILES DENTISTRY, LLC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1 SPRUCE ST
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City | EAST MILLINOCKET
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State | ME
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Zip | 04430-1161
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Country | US
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Telephone | 207-746-9353
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SPRUCE ST
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City | EAST MILLINOCKET
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State | ME
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Zip | 04430-1161
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Country | US
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Telephone | 207-746-9353
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTEN R SCIOLINO
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Credential | DMD
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Telephone | 207-794-6896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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