OrganizationActive
Breakwater Dental, LLC
NPI 1811575202 · General Practice Dentistry · South Portland, ME
Provider details
- NPI number
- 1811575202
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Shilo Annis, Owner/Dentist(207) 272-9847
Specialties & taxonomies
Dental Providers
Practice location
25 Long Creek Dr Unit D
South Portland, ME 04106-2440
Phone: (207) 775-2072
Approximate (ZIP-level) locationGet directions
Mailing address
5 Midnight Ln
Gorham, ME 04038-2376
Registry dates
- Enumerated
- 2021-03-29
- Last updated
- 2021-03-29
- Certified
- 2021-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.