Healthcare Provider Details

I. General information

NPI: 1295140754
Provider Name (Legal Business Name): UNIVERSITY OF VERMONT MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 HINESBURG RD SUITE 202
SOUTH BURLINGTON VT
05403-7628
US

IV. Provider business mailing address

PO BOX 526
BURLINGTON VT
05402-0526
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-1777
  • Fax:
Mailing address:
  • Phone: 802-847-1882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN BRUMSTED
Title or Position: CEO
Credential: MD
Phone: 802-847-1882