Individual
LOUIS ANTHONY BEAUDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
108 EAST MAIN STREET, WILMINGTON, VT 05363
(802) 464-5817
(802) 464-1103
Mailing address
108 EAST MAIN ST., BOX 937, WILMINGTON, VT 05363-0937
(802) 464-5817
(802) 464-1103
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016-0000588
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001693
—
VT
Enumeration date
07/13/2006
Last updated
07/08/2007
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