| Breakwater Dental, Llc | |
|
25 Long Creek Dr Unit D South Portland ME 04106-2440 | |
| (207) 775-2072 | |
| Not Available |
| Full Name | Breakwater Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 25 Long Creek Dr Unit D, South Portland, Maine |
| Authorized Official Name and Position | Shilo Annis (OWNER/DENTIST) |
| Authorized Official Contact | 2072729847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakwater Dental, Llc 5 Midnight Ln Gorham ME 04038-2376 Ph: (207) 272-9847 | Breakwater Dental, Llc 25 Long Creek Dr Unit D South Portland ME 04106-2440 Ph: (207) 775-2072 |
| NPI Number | 1811575202 |
|---|---|
| Provider Enumeration Date | 03/29/2021 |
| Last Update Date | 03/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811575202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Root Dental Specialists Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 192 Western Ave, South Portland, ME 04106 Phone: 207-405-0004 Fax: 207-405-0004 | |
Maine Pediatric Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 85 Western Ave, South Portland, ME 04106 Phone: 207-408-0479 | |
Pkv,inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 192 Western Ave, South Portland, ME 04106 Phone: 207-773-1703 Fax: 207-773-0268 | |
W. David Melevsky, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 Long Creek Dr, South Portland, ME 04106 Phone: 207-761-6699 Fax: 207-761-0245 | |
Gary A Kokx Dmd Todd D Ray Dmd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 Long Creek Dr, 1, South Portland, ME 04106 Phone: 207-774-6553 Fax: 207-774-0496 | |
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