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General NPI Number Information
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NPI Number | 1619114733
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Entity Type | Organization
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Legal Business Name | MARK D KNOTT, DDS, PLC
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 32 PLEASANT ST
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City | WOODSTOCK
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State | VT
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Zip | 05091-1122
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Country | US
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Telephone | 802-457-2922
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Fax | 802-457-1835
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Provider Business Mailing Address
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Address Line | 32 PLEASANT ST
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City | WOODSTOCK
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State | VT
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Zip | 05091-1122
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Country | US
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Telephone | 802-457-2922
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Fax | 802-457-1835
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MARK KNOTT
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Credential | DDS
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Telephone | 802-457-2922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 016-0002246
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License Number State | VT
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