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
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
01/02/2020
Last updated
04/09/2024
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