| Katahdin Family Dental Llc | |
|
254 South St Calais ME 04619-1322 | |
| (207) 454-2350 | |
| (207) 454-2879 |
| Full Name | Katahdin Family Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 254 South St, Calais, Maine |
| Authorized Official Name and Position | Lea Farrar (OFFICE MANAGER) |
| Authorized Official Contact | 2074542350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katahdin Family Dental Llc 254 South St Calais ME 04619-1322 Ph: (207) 454-2350 | Katahdin Family Dental Llc 254 South St Calais ME 04619-1322 Ph: (207) 454-2350 |
| NPI Number | 1407330467 |
|---|---|
| Provider Enumeration Date | 09/17/2018 |
| Last Update Date | 09/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407330467 | NPI | - | NPPES |
| DEN4422 | Other | ME | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
William R. Gould, D.d.s., L.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 399 Main St, Calais, ME 04619 Phone: 207-454-2350 Fax: 207-454-2879 |