| NPI | 1811191158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN ALCALA Dentist 802-878-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 016-0001175) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |