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General NPI Number Information
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NPI Number | 1720877756
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Entity Type | Organization
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Legal Business Name | VUMBACK ORTHODONTICS
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 69 E CENTRAL ST
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City | NATICK
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State | MA
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Zip | 01760-3672
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Country | US
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Telephone | 203-215-7741
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Fax |
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Provider Business Mailing Address
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Address Line | 3 GLASTONBURY PL UNIT 312
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City | GLASTONBURY
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State | CT
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Zip | 06033-4446
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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 | OWNER
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Name | MATTHEW VUMBACK
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Credential | DMD
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Telephone | 203-215-7741
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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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