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Individual

DALE KEVIN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUDIOLOGIST

Contact information

Practice address
111 COLCHESTER AVE, WP4--OTOLARYNGOLOGY, BURLINGTON, VT 05401-1473
(802) 847-4535
Mailing address
111 COLCHESTER AVE, WP4--OTOLARYNGOLOGY, BURLINGTON, VT 05401-1473
(802) 847-4535

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
320471-4101
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
999000021033 D1463
UT
Enumeration date
01/25/2007
Last updated
09/27/2013
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