Individual
PAUL GREGORY BOERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
44 TIMBER LANE, SOUTH BURLINGTON, VT 05403-7282
(802) 860-6725
(802) 864-1511
Mailing address
44 TIMBER LANE, SOUTH BURLINGTON, VT 05403-7282
(802) 860-6725
(802) 864-1511
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0160000990
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102V101
MVP
VT
01
—
8309
BCBS
VT
05
—
9446
—
VT
Enumeration date
07/28/2006
Last updated
07/08/2007
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