| NPI | 1356350565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL A MARTIN President 802-651-9033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VT 0160002160) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |