Organization
CHAMPLAIN PERIODONTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN D HUBER D.M.D., M.S. (OWNER)
(802) 862-1435
Entity
Organization
Contact information
Practice address
37 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 862-1435
(802) 864-6998
Mailing address
37 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 862-1435
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0160002033
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006633
—
VT
Enumeration date
03/28/2007
Last updated
08/22/2020
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