| NPI | 1265103402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SLEEMAN Member 802-447-7987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-27 |