| NPI | 1104229475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARD FREEMAN President 802-862-9196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VT 016.0084809) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2022-02-15 |