Healthcare Provider Details

I. General information

NPI: 1497410393
Provider Name (Legal Business Name): FRANCIS CARON-ROY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 PROUTY DR
NEWPORT VT
05855-9851
US

IV. Provider business mailing address

212 PROUTY DR
NEWPORT VT
05855-9851
US

V. Phone/Fax

Practice location:
  • Phone: 802-334-6965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number016.0134041
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: