PERIODONTAL ASSOCIATES NPI 1932329943

NPI Information

  • NPI: 1932329943
  • Provider Name: PERIODONTAL ASSOCIATES
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Address: 612 BRIGHTON AVE
    PORTLAND, ME
    ZIP 04102
  • Phone: (207) 772-7459

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NPI Details

PERIODONTAL ASSOCIATES is a periodontics dentist in Portland, ME. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL ASSOCIATES NPI is 1932329943. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

612 BRIGHTON AVE
PORTLAND, ME
ZIP 04102-359
Phone: (207) 772-7459
Fax: (207) 874-6460

The provider's authorized official is George D Gordon .
The authorized official title is President and has the following contact phone number (207) 772-7459.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 8/22/2020.

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
11223P0300XDentistPeriodontics2204MAINEYes

What is NPI?

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

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