| Colchester Dental Group | |
|
106 High Point Ctr Suite 100 Colchester VT 05446-5861 | |
| (802) 655-5308 | |
| (802) 655-5715 |
| Full Name | Colchester Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 106 High Point Ctr, Colchester, Vermont |
| Authorized Official Name and Position | Kenneth Palm (DENTIST) |
| Authorized Official Contact | 8026555308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colchester Dental Group 106 High Point Ctr Suite 100 Colchester VT 05446-5861 Ph: (802) 655-5308 | Colchester Dental Group 106 High Point Ctr Suite 100 Colchester VT 05446-5861 Ph: (802) 655-5308 |
| NPI Number | 1871707786 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 07/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871707786 | NPI | - | NPPES |
| 1005081 | Medicaid | VT | |
| 01237 | Other | VT | STATE DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 01237 (Vermont) | Primary |
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