MALLETT'S BAY DENTISTRY NPI 1477851723

NPI Information

MALLETT'S BAY DENTISTRY is a dental clinic center in Colchester, VT. MALLETT'S BAY DENTISTRY NPI is 1477851723. The provider is registered as an organization entity type.

The provider's business location address is:

97 BLAKELY RD
SUITE 104
COLCHESTER, VT
ZIP 05446-008
Phone: (802) 862-8266
Fax: (802) 862-6416

The provider's authorized official is Denham B. Crafton .
The authorized official title is Ceo and has the following contact phone number (802) 862-8266.

The enumeration date for this NPI number is 3/10/2011 and was last updated on 3/10/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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