NPI | 1558483321 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL LANG ULLMAN President 802-773-7767 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VT 1124) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2020-08-22 |