Southern Maine Periodontal Assoc Pa is a Periodontology Clinic in Portland, Maine. It is located at 276 Canco Rd, Portland, ME and its contact number is 207-780-1822. The authorized person for Southern Maine Periodontal Assoc Pa is Dr. Denise M Theriault
who is Owner of the clinic and their contact number is 207-780-1922. The primary license number for Southern Maine Periodontal Assoc Pa is 3390 (Periodontics) in Maine.
Southern Maine Periodontal Assoc Pa Clinic is specialized in that branch 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.
Complete Clinic Profile:
Southern Maine Periodontal Assoc Pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Southern Maine Periodontal Assoc Pa |
| Specialization: | Periodontology |
| Clinic Address: | 276 Canco Rd, Portland,
Maine, 04103 |
| Phone: | 207-780-1822 |
| Fax: | 207-780-6022 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Denise M Theriault |
| Position: | Owner |
| Contact Number: | 207-780-1922 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Southern Maine Periodontal Assoc Pa clinic are as mentioned below.
| NPI Number: | 1295828069 |
| NPI Enumeration Date: | 02 Oct, 2006 |
| NPI Last Update On: | 22 Aug, 2020 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southern Maine Periodontal Assoc Pa are as mentioned below.
| Specialization | License Number | State | Status | |
| Periodontics | 3390 | Maine | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Southern Maine Periodontal Assoc Pa
276 Canco Rd,
Portland, Maine |
| Zip: | 04103 |
| Phone Number: | 207-780-1822 |
| Fax Number: | 207-780-6022 |
Patients can reach Southern Maine Periodontal Assoc Pa at
276 Canco Rd, Portland, Maine or can
call to book an appointment on 207-780-1822.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.