Breakwater Dental, LLC
NPI #1811575202 in South Portland, Maine
Provider Information
- NPI Number
- 1811575202
- Entity Type
- Organization
- Organization Name
- Breakwater Dental, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 29, 2021
- Last Updated
- Mar 29, 2021
Practice Location
- Address
- 25 LONG CREEK DR UNIT D
- City
- South Portland
- State
- Maine
- ZIP Code
- 04106-2440
- Phone
- (207) 775-2072
Authorized Official
- Name
- DR. SHILO ANNIS, DMD
- Title
- OWNER/DENTIST
- Phone
- (207) 272-9847
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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