| Vermont Dental Medicine Pllc | |
|
40 Timber Ln South Burlington VT 05403-7204 | |
| (802) 862-7185 | |
| (802) 658-8036 |
| Full Name | Vermont Dental Medicine Pllc |
|---|---|
| Speciality | Dentist |
| Location | 40 Timber Ln, South Burlington, Vermont |
| Authorized Official Name and Position | Reimy Evangelista De Leon (OWNER) |
| Authorized Official Contact | 7813850484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vermont Dental Medicine Pllc 40a Timber Ln South Burlington VT 05403-7204 Ph: (802) 862-7185 | Vermont Dental Medicine Pllc 40 Timber Ln South Burlington VT 05403-7204 Ph: (802) 862-7185 |
| NPI Number | 1932245362 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 05/28/2024 |
| Medicare PECOS PAC ID | 6406381730 |
|---|---|
| Medicare Enrollment ID | O20241125000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932245362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 122300000X | Dentist | 016-0000615 (Vermont) | Primary |
| Provider Name | Reimy Evangelista De Leon |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1750867800 PECOS PAC ID: 3971964586 Enrollment ID: I20230731000144 |
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