| NPI | 1598916579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS A GALLIVAN President 802-773-1393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VT 016-0000583) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |