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Organization
VT CENTER FOR DENTAL IMPLANTS AND MAXILLOFACIAL SURGERY LLC
Active
Organization
VT CENTER FOR DENTAL IMPLANTS AND MAXILLOFACIAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN DESLAURIERS (BILLING MANAGER)
(802) 655-5090
Entity
Organization
Contact information
Practice address
1009 S MAIN ST STE 1, STOWE, VT 05672-5275
(802) 253-2761
(802) 655-9366
Mailing address
792 COLLEGE PKWY STE 307, COLCHESTER, VT 05446-3052
(802) 655-5090
(800) 524-4660
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
01/02/2020
Last updated
04/09/2024
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