| Katahdin Pediatric Dentistry | |
|
24 Penn Plz Bangor ME 04401-3620 | |
| (207) 942-0593 | |
| (207) 947-5237 |
| Full Name | Katahdin Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 24 Penn Plz, Bangor, Maine |
| Authorized Official Name and Position | Gaston To'olo (PEDIATRIC DENTIST) |
| Authorized Official Contact | 2079420593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katahdin Pediatric Dentistry 24 Penn Plz Bangor ME 04401-3620 Ph: (207) 942-0593 | Katahdin Pediatric Dentistry 24 Penn Plz Bangor ME 04401-3620 Ph: (207) 942-0593 |
| NPI Number | 1013274067 |
|---|---|
| Provider Enumeration Date | 04/16/2012 |
| Last Update Date | 11/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013274067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4096 (Maine) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 3063 (Maine) | Secondary |
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