| NPI | 1457653792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGE ELLIS Office Manager 802-885-4581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 03516) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2010-11-18 |