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General NPI Number Information
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NPI Number | 1568174159
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Entity Type | Organization
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Legal Business Name | VERMONT FAMILY DENTAL PLC
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Dates
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Enumeration Date | 12/15/2022
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 135 N MAIN ST STE 1
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City | RUTLAND
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State | VT
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Zip | 05701-3238
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Country | US
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Telephone | 802-770-1730
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Fax |
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Provider Business Mailing Address
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Address Line | 135 N MAIN ST STE 1
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City | RUTLAND
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State | VT
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Zip | 05701-3238
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Country | US
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Telephone | 802-770-1730
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | JP RABBATH
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Credential |
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Telephone | 617-947-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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