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Individual

DR. MARY KATHRYN DELOACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
60 TIMBER LN, SOUTH BURLINGTON, VT 05403-7214
(802) 864-6881
Mailing address
78 EASTWOOD DR, 309, SOUTH BURLINGTON, VT 05403-4497
(203) 623-6193

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016.0095505
VT
390200000X
Student in an Organized Health Care Education/Training Program
VT

Other

Enumeration date
04/01/2012
Last updated
05/30/2013
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