| NPI | 1124454145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONI GOLDEN Dentist 802-878-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VT 0160088849) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VT 0160000525) |
| 1223G0001X Dentist General Practice (Licence: VT 0160000534) | |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2013-09-24 |