Individual
K. MARTIN SIMON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
391 S MAIN ST, NORTHFIELD, VT 05663-5745
(802) 485-3051
(802) 485-8384
Mailing address
391 S MAIN ST, NORTHFIELD, VT 05663-5745
(802) 485-3051
(802) 485-8384
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
785
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002415
—
VT
Enumeration date
06/16/2006
Last updated
07/08/2007
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