| NPI | 1013286376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E MCLEAN Owner/ President 802-864-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 016.0002101) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2011-12-15 |