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General NPI Number Information
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NPI Number | 1710950092
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Entity Type | Organization
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Legal Business Name | NORTHERN VERMONT ORAL & FACIAL SURGERY
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 310 FISHER RD SUITE 1
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City | BERLIN
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State | VT
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Zip | 05602-9162
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Country | US
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Telephone | 802-223-2364
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Fax | 802-223-9691
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Provider Business Mailing Address
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Address Line | 310 FISHER RD SUITE 1
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City | BERLIN
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State | VT
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Zip | 05602-9162
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Country | US
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Telephone | 802-223-2364
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Fax | 802-223-9691
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JEFFREY W GLOSSER
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Credential | DDS
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Telephone | 802-223-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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