KATAHDIN PEDIATRIC DENTISTRY NPI 1013274067

NPI Information

  • NPI: 1013274067
  • Provider Name: KATAHDIN PEDIATRIC DENTISTRY
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Address: 24 PENN PLZ
    BANGOR, ME
    ZIP 04401
  • Phone: (207) 942-0593

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NPI Details

KATAHDIN PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Bangor, ME. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. KATAHDIN PEDIATRIC DENTISTRY NPI is 1013274067. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

24 PENN PLZ
BANGOR, ME
ZIP 04401-620
Phone: (207) 942-0593
Fax: (207) 947-5237

The provider's authorized official is Gaston To'olo .
The authorized official title is Pediatric Dentist and has the following contact phone number (207) 942-0593.

The enumeration date for this NPI number is 4/16/2012 and was last updated on 11/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry3063MAINENo
21223P0221XDentistPediatric Dentistry4096MAINEYes

What is NPI?

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This page was last updated on: 11/21/2025

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