BREAKWATER DENTAL, LLC

SOUTH PORTLAND, ME
NPI1811575202
Entity TypeOrganization
Authorized ContactSHILO ANNIS
Owner/Dentist
207-272-9847
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
Enumeration Date2021-03-29
Last Update Date2021-03-29
Business Address
BREAKWATER DENTAL, LLC
25 LONG CREEK DR UNIT D
SOUTH PORTLAND, ME 04106-2440
Phone number: 207-775-2072
Mailing Address
BREAKWATER DENTAL, LLC
5 MIDNIGHT LN
GORHAM, ME 04038-2376
Phone number: 207-272-9847
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