Organization
TACONIC DENTAL ARTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TYLER JUSTIN CARMACK DMD (OWNER)
(802) 773-1020
Entity
Organization
Contact information
Practice address
163 JACKSON AVE, RUTLAND, VT 05701-4500
(802) 442-9500
Mailing address
163 JACKSON AVE, RUTLAND, VT 05701-4500
(802) 442-9500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0160073365
VT
Other
Enumeration date
10/21/2016
Last updated
02/23/2018
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