H | |
79 South Windsor St South Royalton VT 05068-0119 | |
(802) 889-3310 | |
(802) 763-2190 |
Full Name | H |
---|---|
Speciality | Dentist - General Practice |
Location | 79 South Windsor St, South Royalton, Vermont |
Authorized Official Name and Position | Susan Hull (CLINIC COORDINATOR) |
Authorized Official Contact | 8028893310 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
H Po Box 119 South Royalton VT 05068-0119 Ph: (802) 889-3310 | H 79 South Windsor St South Royalton VT 05068-0119 Ph: (802) 889-3310 |
NPI Number | 1356633895 |
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Provider Enumeration Date | 05/03/2011 |
Last Update Date | 05/03/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356633895 | NPI | - | NPPES |
1016989 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 659 (Vermont) | Primary |