Organization
NEW ENGLAND ORAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA MELVIN (PRACTICE MANAGER)
(802) 622-0678
Entity
Organization
Contact information
Practice address
14 N MAIN ST, SUITE 4001, BARRE, VT 05641-4197
(802) 622-0323
Mailing address
14 N MAIN ST, SUITE 4001, BARRE, VT 05641-4197
(802) 622-0323
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
016.0002059
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034668
MEDICARE PTAN
—
05
—
1022121
—
VT
Enumeration date
04/11/2013
Last updated
02/03/2014
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