| Green Mountain Pediatric Dentistry, Pllc | |
|
42 Timber Ln South Burlington VT 05403-7204 | |
| (802) 332-6808 | |
| (802) 332-6807 |
| Full Name | Green Mountain Pediatric Dentistry, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 42 Timber Ln, South Burlington, Vermont |
| Authorized Official Name and Position | Barry L Jacobson (OWNER) |
| Authorized Official Contact | 8023326808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Mountain Pediatric Dentistry, Pllc 42 Timber Ln South Burlington VT 05403-7204 Ph: (802) 332-6808 | Green Mountain Pediatric Dentistry, Pllc 42 Timber Ln South Burlington VT 05403-7204 Ph: (802) 332-6808 |
| NPI Number | 1912469297 |
|---|---|
| Provider Enumeration Date | 04/04/2019 |
| Last Update Date | 04/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912469297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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