# MIDDLEBURY PEDIATRIC DENTISTRY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Middlebury Pediatric Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053937292
- **Authorized official:** DR. BRIAN D COLLINS DDS (OWNER / MEMBER)
- **Authorized official phone:** (802) 388-0909

## Contact information

- **Practice address:** 132 S VILLAGE GRN, MIDDLEBURY, VT 05753-6900
- **Practice address phone:** (802) 388-0909
- **Practice address fax:** (802) 989-7095
- **Mailing address:** 132 S VILLAGE GRN, MIDDLEBURY, VT 05753-6900
- **Mailing address phone:** (802) 388-0909
- **Mailing address fax:** (802) 989-7095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2020
- **Last updated:** 06/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1022015 | — | VT |