Provider Demographics
NPI:1275418261
Name:SACO BAY DENTAL WELLNESS LLC
Entity type:Organization
Organization Name:SACO BAY DENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL HYGIENIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LATULIP
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, IPDH
Authorized Official - Phone:207-503-0003
Mailing Address - Street 1:108 CYR RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3704
Mailing Address - Country:US
Mailing Address - Phone:603-366-6132
Mailing Address - Fax:
Practice Address - Street 1:238 NORTH ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1870
Practice Address - Country:US
Practice Address - Phone:207-503-0003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty