Healthcare Provider Details

I. General information

NPI: 1245347806
Provider Name (Legal Business Name): FOREST FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 RIVER ST
MONTPELIER VT
05602-3750
US

IV. Provider business mailing address

81 RIVER ST
MONTPELIER VT
05602-3750
US

V. Phone/Fax

Practice location:
  • Phone: 802-229-0033
  • Fax: 802-229-0031
Mailing address:
  • Phone: 802-229-0033
  • Fax: 802-229-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateVT

VIII. Authorized Official

Name: DR. LAUNE ANN FOREST
Title or Position: OWNER
Credential: DDS
Phone: 802-229-0033