| NPI | 1609090190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNIE COMPANION Office Manager 802-899-3973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 0160000916) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-09-26 |