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General NPI Number Information
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NPI Number | 1538045455
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Entity Type | Individual
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Provider Name | KATIE PORT RDH,IPDH
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Gender | Female
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 68 BEN PAUL LN
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City | ROCKPORT
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State | ME
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Zip | 04856-4452
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Country | US
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Telephone | 207-441-2506
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Fax |
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Provider Business Mailing Address
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Address Line | 275 HALLOWELL RD
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City | CHELSEA
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State | ME
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Zip | 04330-1126
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Country | US
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Telephone | 207-441-2506
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | RDH3073
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License Number State | ME
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