Vt Center for Dental Implants and Maxillofacial Surgery LLC

NPI #1063699767 in Colchester, Vermont

Provider Information

NPI Number: 1063699767
Entity Type: Organization
Organization Name: Vt Center for Dental Implants and Maxillofacial Surgery LLC
Primary Specialty: Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date: Jan 24, 2008
Last Updated: Apr 25, 2024

Practice Location

Address: 792 COLLEGE PKWY STE 307
City: Colchester
State: Vermont
ZIP Code: 05446-3052
Phone: (802) 655-5090

Authorized Official

Name: LISA MARIE DIKE
Title: PRACTICE MANAGER
Phone: (802) 655-5090

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Durable Medical Equipment & Medical Supplies	332B00000X
Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	261QS0112X	Primary

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