NPI | 1326139130 |
---|---|
Entity Type | Organization |
Authorized Contact | DOROTHY WATSON Administrator 802-264-6909 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
1223P0300X Dentist, Periodontics | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2006-09-27 |
Last Update Date | 2020-08-22 |