Healthcare Provider Details

I. General information

NPI: 1538093620
Provider Name (Legal Business Name): ABIGAIL LAROCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

472 WEBSTER RD
WHITING VT
05778-9541
US

IV. Provider business mailing address

472 WEBSTER RD
WHITING VT
05778-9541
US

V. Phone/Fax

Practice location:
  • Phone: 802-377-0888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number013.0160182
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: