Individual
BRENNAN M THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 652-1087
Mailing address
229 STONEHILL RD, WILLISTON, VT 05495-9521
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
160000530
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001750
—
VT
01
—
160000530
STATE LICENSE
VT
Enumeration date
10/05/2006
Last updated
08/25/2010
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