Organization
MYORTHOS VERMONT ORTHODONTICS PC
Active
Parent organization
MYORTHOS VERMONT ORTHODONTICS PC
Other names
Champlain Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
MYORTHOS VERMONT ORTHODONTICS PC
Authorized official
CASEY LONABOCKER (VP OPERATIONS & STRATEGY)
(617) 535-3364
Entity
Organization
Contact information
Practice address
277 BLAIR PARK RD STE 101, WILLISTON, VT 05495-7885
(802) 878-5323
Mailing address
131 DARTMOUTH ST FL 3, BOSTON, MA 02116-5297
(617) 665-7241
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
11/20/2024
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