Organization
STRATTON DENTAL ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER J CARMACK D.M.D. (OWNER/OPERATOR)
(802) 442-9500
Entity
Organization
Contact information
Practice address
163 STRATTON RD, RUTLAND, VT 05701-4619
(802) 442-9500
Mailing address
163 STRATTON RD, RUTLAND, VT 05701-4619
(802) 442-9500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0160073365
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701100805
—
VT
Enumeration date
07/31/2018
Last updated
07/31/2018
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