| NPI | 1356633895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN HULL Clinic Coordinator 802-889-3310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 659) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |