Organization
WATERBURY FAMILY DENTISTRY, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L. MORRIS DDS (OWNER/DENTIST)
(802) 244-6366
Entity
Organization
Contact information
Practice address
77 S. MAIN ST., SUITE 3, WATERBURY, VT 05676
(802) 244-6366
(802) 244-8514
Mailing address
77 S. MAIN ST., SUITE 3, WATERBURY, VT 05676
(802) 244-6366
(802) 244-8514
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0160001187
VT
1223G0001X
General Practice Dentistry
2031
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004239
—
UT
Enumeration date
07/18/2007
Last updated
10/11/2011
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