| NPI | 1174633580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KENT SHAFER Dentist/Owner 802-674-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 692) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-04-12 |