| NPI | 1063786374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN MELO Owner/Dentist 802-863-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VT 0160002103) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |