Individual
MR. JAMES VINCENT WYLLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
212 PROUTY DR, SUITE 1, NEWPORT, VT 05855-9851
(802) 334-6965
(802) 334-6606
Mailing address
212 PROUTY DR, SUITE 1, NEWPORT, VT 05855-9851
(802) 334-6965
(802) 334-6606
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
652
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000-1845
—
VT
Enumeration date
10/24/2006
Last updated
07/08/2007
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