| NPI | 1679786842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MONROE PITMON Owner 802-862-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VT 016-0001072) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-01-28 |