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Organization
MALLETT'S BAY DENTISTRY
Active
Organization
MALLETT'S BAY DENTISTRY
Active
Parent organization
CRAFTON FAMILY DENTISTRY, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRAFTON FAMILY DENTISTRY, PLLC
Authorized official
DR. DENHAM B. CRAFTON II D.M.D. (CEO)
(802) 862-8266
Entity
Organization
Contact information
Practice address
97 BLAKELY RD, SUITE 104, COLCHESTER, VT 05446-4008
(802) 862-8266
(802) 862-6416
Mailing address
97 BLAKELY RD, SUITE 104, COLCHESTER, VT 05446-4008
(802) 862-8266
(802) 862-6416
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
016-0002281
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015584
—
VT
Enumeration date
03/10/2011
Last updated
03/10/2011
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