Healthcare Provider Details
I. General information
NPI: 1144043530
Provider Name (Legal Business Name): CVO AQUISITION PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
85 WASHINGTON ST STE 2
BARRE VT
05641-4297
US
IV. Provider business mailing address
85 WASHINGTON ST STE 2
BARRE VT
05641-4297
US
V. Phone/Fax
- Phone: 802-476-6373
- Fax:
- Phone: 802-476-6373
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GARY
E
BEDROSIAN
Title or Position: OWNER
Credential: DDS, MSD
Phone: 518-429-3791