| Coastal Family Dental | |
|
110 Auburn Street Portland ME 04103 | |
| (207) 797-7433 | |
| (207) 797-7720 |
| Full Name | Coastal Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 110 Auburn Street, Portland, Maine |
| Authorized Official Name and Position | Alexandra Yamva Peacock Cathcart (OWNER) |
| Authorized Official Contact | 4134466346 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Family Dental 110 Auburn Street Portland ME 04103 Ph: (207) 797-7433 | Coastal Family Dental 110 Auburn Street Portland ME 04103 Ph: (207) 797-7433 |
| NPI Number | 1154446672 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 06/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154446672 | NPI | - | NPPES |
| 124010000 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3047 (Maine) | Primary |
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