| Taconic Dental Arts Pc | |
|
163 Jackson Ave Rutland VT 05701-4500 | |
| (802) 442-9500 | |
| Not Available |
| Full Name | Taconic Dental Arts Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 163 Jackson Ave, Rutland, Vermont |
| Authorized Official Name and Position | Tyler Justin Carmack (OWNER) |
| Authorized Official Contact | 8027731020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Taconic Dental Arts Pc 163 Jackson Ave Rutland VT 05701-4500 Ph: (802) 442-9500 | Taconic Dental Arts Pc 163 Jackson Ave Rutland VT 05701-4500 Ph: (802) 442-9500 |
| NPI Number | 1417408717 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 02/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417408717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0160073365 (Vermont) | Primary |
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