is a Oral and Maxillofacial Dental Clinic in Colchester, Vermont. It is located at 792 College Pkwy Ste 307, Colchester, VT and its contact number is 802-655-5090. The authorized person for is Lisa Marie Dike
who is Practice Manager of the clinic and their contact number is 802-655-5090. The primary license number for is 061-0001123 (Oral and Maxillofacial Surgery) in Vermont. Clinic deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
Oral and Maxillofacial Surgery
Clinic Address:
792 College Pkwy Ste 307, Colchester, Vermont, 05446-3052
Phone:
802-655-5090
Fax:
802-655-9366
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Lisa Marie Dike
Position:
Practice Manager
Contact Number:
802-655-5090
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1063699767
NPI Enumeration Date:
24 Jan, 2008
NPI Last Update On:
25 Apr, 2024
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
Oral and Maxillofacial Surgery
061-0001123
Vermont
Primary
Oral and Maxillofacial Surgery
016-0001123
Vermont
Secondary
Durable Medical Equipment & Medical Supplies
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
1003069
Medicaid
Vermont
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
792 College Pkwy Ste 307, Colchester, Vermont
Zip:
05446-3052
Phone Number:
802-655-5090
Fax Number:
802-655-9366
Patients can reach at 792 College Pkwy Ste 307, Colchester, Vermont or can call to book an appointment on 802-655-5090. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.