Organization
WILLARD STREET FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM C DESANCTIS (DENTIST)
(802) 868-4792
Entity
Organization
Contact information
Practice address
27 N WILLARD ST, BURLINGTON, VT 05401-3312
(802) 862-8625
Mailing address
27 N WILLARD ST, BURLINGTON, VT 05401-3312
(802) 862-8625
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0160002122
VT
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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