Organization
MAINE TINY DENTAL ELIOT LLC
Active
Other names
MAINE TINY DENTAL ELIOT LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI DESOUZA (IPDH/OWNER/PRESIDENT)
(207) 500-1525
Entity
Organization
Contact information
Practice address
150 DOW HWY, ELIOT, ME 03903-2091
(207) 500-3673
Mailing address
303 KIMBALL POND RD, NEW SHARON, ME 04955-3703
(207) 500-1525
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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