Individual
LOREN T PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
119 UNION ST, BENNINGTON, VT 05201-2406
(802) 442-6379
Mailing address
119 UNION ST, BENNINGTON, VT 05201-2406
(802) 442-6379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1129
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003050
—
VT
Enumeration date
10/12/2006
Last updated
07/08/2007
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