| NPI | 1568403061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK IACONO Owner/President 802-775-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 813) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VT 815) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2009-05-04 |