Green Mountain Pediatric Dentistry, Pllc
NPI #1912469297 in South Burlington, Vermont
Provider Information
- NPI Number
- 1912469297
- Entity Type
- Organization
- Organization Name
- Green Mountain Pediatric Dentistry, Pllc
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Apr 4, 2019
- Last Updated
- Apr 4, 2019
Practice Location
- Address
- 42 TIMBER LN
- City
- South Burlington
- State
- Vermont
- ZIP Code
- 05403-7204
- Phone
- (802) 332-6808
Authorized Official
- Name
- BARRY L JACOBSON, DMD
- Title
- OWNER
- Phone
- (802) 332-6808
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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