Provider Demographics
NPI:1043018831
Name:KATAHDIN SMILES DENTISTRY, LLC
Entity type:Organization
Organization Name:KATAHDIN SMILES DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCIOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-794-6896
Mailing Address - Street 1:1 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:EAST MILLINOCKET
Mailing Address - State:ME
Mailing Address - Zip Code:04430-1161
Mailing Address - Country:US
Mailing Address - Phone:207-746-9353
Mailing Address - Fax:
Practice Address - Street 1:1 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:EAST MILLINOCKET
Practice Address - State:ME
Practice Address - Zip Code:04430-1161
Practice Address - Country:US
Practice Address - Phone:207-746-9353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental