Individual
DR. JOHN GORDON STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
584 OAK HILL RD, THOMAS CHITTENDEN HEALTH CENTER, WILLISTON, VT 05495-7103
(802) 878-2933
(802) 872-1162
Mailing address
584 OAK HILL RD, THOMAS CHITTENDEN HEALTH CENTER, WILLISTON, VT 05495-7103
(802) 878-2933
(802) 872-1162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
604
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000-1776
—
VT
01
—
919-1776
PROVIDER NUMBER
VT
Enumeration date
07/17/2006
Last updated
07/09/2007
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