Healthcare Provider Details

I. General information

NPI: 1174533327
Provider Name (Legal Business Name): SCHRAMM AND SYMANCYK, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 NORTH HARTLAND ROAD
WHITE RIVER JUNCTION VT
05001
US

IV. Provider business mailing address

PO BOX 948
WHITE RIVER JUNCTION VT
05001-0948
US

V. Phone/Fax

Practice location:
  • Phone: 802-295-2458
  • Fax: 802-295-3985
Mailing address:
  • Phone: 802-295-2458
  • Fax: 802-295-3985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number106.0086114
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberVT625
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberVT1028
License Number StateVT

VIII. Authorized Official

Name: RICHARD G SCHRAMM
Title or Position: CO OWNER GENERAL DENTIST
Credential: DMD
Phone: 802-295-2458