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Individual

DR. GLEN B MOYER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D. D. S.

Contact information

Practice address
564 ROUTE 2, SUITE 2, SOUTH HERO, VT 05486-4307
(802) 372-3737
Mailing address
55 TOWNLINE RD, GRAND ISLE, VT 05458-2563
(802) 372-6050

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016-0000773
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00002404
VT
Enumeration date
06/17/2006
Last updated
07/08/2007
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