| NPI | 1457638892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE BLICHER Owner 802-295-7522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VT 49567) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: VT 016.0093923) |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2014-02-17 |