Organization
COMMUNITY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY PELKEY (BILLING COORDINATOR)
(207) 874-1025
Entity
Organization
Contact information
Practice address
333 LINCOLN ST, SACO, ME 04072-3113
(207) 282-1305
Mailing address
333 LINCOLN ST, SACO, ME 04072-3113
(207) 282-1305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167870002
—
ME
Enumeration date
11/28/2006
Last updated
08/22/2020
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