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Organization
GREEN MOUNTAIN PEDIATRIC DENTISTRY, PLLC
Active
Organization
GREEN MOUNTAIN PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY L JACOBSON DMD (OWNER)
(802) 332-6808
Entity
Organization
Contact information
Practice address
42 TIMBER LN, SOUTH BURLINGTON, VT 05403-7204
(802) 332-6808
(802) 332-6807
Mailing address
42 TIMBER LN, SOUTH BURLINGTON, VT 05403-7204
(802) 332-6808
(802) 332-6807
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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