Individual
DENNIS SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12 CHURCH ST, SWANTON, VT 05488-1403
(802) 868-3175
(802) 868-2923
Mailing address
PO BOX 1346, WILLISTON, VT 05495-1346
(802) 524-7100
(802) 524-7021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
055-0030446
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001761
—
VT
Enumeration date
03/20/2006
Last updated
07/08/2007
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