Full Name | |
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Speciality | Dentist - General Practice |
Location | 26 Canada St, Swanton, Vermont |
Authorized Official Name and Position | Kathy Benoit (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8022555562 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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44 Main St Suite 200 Richford VT 05476-1153 Ph: (802) 255-5581 | 26 Canada St Swanton VT 05488-1335 Ph: (802) 868-2454 |
NPI Number | 1790160984 |
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Provider Enumeration Date | 07/29/2015 |
Last Update Date | 08/29/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790160984 | NPI | - | NPPES |
1025842 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |