Organization
WEST RIVER FAMILY DENTAL BRATTLEBORO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED VERNON REDISKE D.D.S. (OWNER)
(802) 254-8322
Entity
Organization
Contact information
Practice address
36 PARK PL, BRATTLEBORO, VT 05301-2802
(802) 254-8322
(802) 258-9013
Mailing address
36 PARK PL, BRATTLEBORO, VT 05301-2802
(802) 254-8322
(802) 258-9013
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
016-0002226
VT
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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