Organization
KATAHDIN VALLEY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DURWARD L HUMPHREY (CEO)
(207) 528-2285
Entity
Organization
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-7000
(207) 528-2880
Mailing address
PO BOX 500, PATTEN, ME 04765-0500
(207) 528-2285
(207) 528-2880
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431497600
—
ME
Enumeration date
09/17/2007
Last updated
05/17/2016
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