Organization
KATAHDIN FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEA FARRAR (OFFICE MANAGER)
(207) 454-2350
Entity
Organization
Contact information
Practice address
254 SOUTH ST, CALAIS, ME 04619-1322
(207) 454-2350
(207) 454-2879
Mailing address
254 SOUTH ST, CALAIS, ME 04619-1322
(207) 454-2350
(207) 454-2879
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DEN4422
DENTAL LICENSE
ME
Enumeration date
09/17/2018
Last updated
09/17/2018
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