| H | |
|
79 South Windsor St South Royalton VT 05068-0119 | |
| (802) 889-3310 | |
| (802) 763-2190 |
| Full Name | H |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 79 South Windsor St, South Royalton, Vermont |
| Authorized Official Name and Position | Susan Hull (CLINIC COORDINATOR) |
| Authorized Official Contact | 8028893310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| H Po Box 119 South Royalton VT 05068-0119 Ph: (802) 889-3310 | H 79 South Windsor St South Royalton VT 05068-0119 Ph: (802) 889-3310 |
| NPI Number | 1356633895 |
|---|---|
| Provider Enumeration Date | 05/03/2011 |
| Last Update Date | 05/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356633895 | NPI | - | NPPES |
| 1016989 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 659 (Vermont) | Primary |