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General NPI Number Information
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NPI Number | 1669547576
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Entity Type | Organization
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Legal Business Name | DENNIS E. LEBLANC, D.D.S.
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 296 MAIN ST.
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City | DERBY
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State | VT
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Zip | 05829
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Country | US
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Telephone | 802-766-4711
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Fax |
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Provider Business Mailing Address
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Address Line | 296 MAIN ST.
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City | DERBY
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State | VT
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Zip | 05829
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CYNTHIA LEBLANC
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Credential |
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Telephone | 802-766-4711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 687
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License Number State | VT
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