MEDICARE: BATTENKILL VALLEY HEALTH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	016.0000905	VT

General Provider Information

NPI Number	:	1700327673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATTENKILL VALLEY HEALTH CENTER

Provider Business Mailing Address
First Line	:	PO BOX 61
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-0061
Country	:	US
Telephone Number	:	802-375-6566
Fax Number	:	802-375-6828

Provider Business Practice Location Address
First Line	:	9 CHURCH ST
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-4457
Country	:	US
Telephone Number	:	802-375-6566
Fax Number	:	802-375-6828

Authorized Official
Title or Position	:	DIRECTOR OF PRACTICE ADMINISTRATION
Name	:	JENIFER PETRY
Credential	:
Telephone Number	:	802-430-7254

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	03/13/2017

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