| NPI | 1013562636 |
|---|---|
| Doing Business As | RED CLOVER FAMILY DENTISTRY |
| Doing Business As | MOUNTAIN COMMUNITY HEALTH |
| Entity Type | Organization |
| Authorized Contact | HEIDI MELBOSTAD Chief Executive Officer 802-453-5116 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2024-09-18 |