| NPI | 1780886036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERILYNN STOFKA Oral Surgeon 802-775-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: VT 0160002076) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |