Downeast Pediatric Dentistry PLLC
Dentist, Pediatric Dentistry in Portland, ME. Organization (NPI-2).
NPI number1720656705
StatusActive
Last updated in NPPESAug 11, 2025
Details
- NPI
- 1720656705
- Entity type
- Organization (NPI-2)
- Legal business name
- Downeast Pediatric Dentistry PLLC
- Organization subpart
- No
- Enumeration date
- Jun 15, 2021
- Certification date
- Aug 11, 2025
- Last updated
- Aug 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
Practice location
888 Brighton AvePortland, ME 04102-1004
Phone 207-772-4111 · Fax 207-761-6953
Mailing address
716 N Country Club RdTucson, AZ 85716-4591
Phone 520-326-8516 · Fax 520-326-1012
Authorized official
Mariah Thibault
Chief Operations Officer
5202762220
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