NPI | 1568692515 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN C DUBOFF President 802-773-1393 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 016 0002240) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: 016-0002241) |
Enumeration Date | 2009-07-23 |
Last Update Date | 2009-07-23 |