| NPI | 1306215025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MASON President 802-362-1099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VT 016.0110862) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |