| NPI | 1871822627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIPPE D CHARLEBOIS Dentist 802-985-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 016.0002291) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2011-02-28 |