Individual
MURRAY DINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
53 MAIN ST, RICHFORD, VT 05476-1151
(802) 848-3829
(802) 848-3849
Mailing address
212 PROUTY DRIVE, SUITE 1, NEWPORT, VT 05855
(802) 334-6965
(802) 334-6606
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
016.0002044
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006289
—
VT
Enumeration date
12/07/2005
Last updated
06/10/2015
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