Organization
VERMONT ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WILLIAM CONNOLLY DMD (PARTNER)
(802) 860-6725
Entity
Organization
Contact information
Practice address
44 TIMBER LANE, SOUTH BRIGHTON, VT 05403-7282
(802) 860-6725
(802) 864-1511
Mailing address
44 TIMBER LANE, SOUTH BRIGHTON, VT 05403-7282
(802) 860-6725
(802) 864-1511
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001515
—
VT
Enumeration date
07/27/2006
Last updated
08/22/2020
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