| NPI | 1053757138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM PURDY Owner 802-872-3593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VT 016.0001134) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2013-08-29 |