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NPI Code Detail

MEDICARE: DR. ELEANOR CLARE KELLY SARLE DDS

MEDICARE: DR. ELEANOR CLARE KELLY SARLE DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryRES210ME

General Provider Information

NPI Number : 1891620373
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELEANOR CLARE KELLY SARLE DDS
Provider Business Mailing Address
First Line : 190 PARK AVE
Second Line :
City : PORTLAND
State : ME
Zip : 04102-2910
Country : US
Telephone Number : 207-874-1028
Fax Number :
Provider Business Practice Location Address
First Line : 190 PARK AVE
Second Line :
City : PORTLAND
State : ME
Zip : 04102-2910
Country : US
Telephone Number : 207-874-1028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ DR. ELEANOR CLARE KELLY SARLE DDS” Practice Location

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