Provider Demographics
NPI:1154306298
Name:THE RICHFORD HEALTH CENTER INC.
Entity Type:Organization
Organization Name:THE RICHFORD HEALTH CENTER INC.
Other - Org Name:RICHFORD DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-255-5562
Mailing Address - Street 1:44 MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:RICHFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05476-1141
Mailing Address - Country:US
Mailing Address - Phone:802-255-5520
Mailing Address - Fax:802-255-5529
Practice Address - Street 1:44 MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:RICHFORD
Practice Address - State:VT
Practice Address - Zip Code:05476-1141
Practice Address - Country:US
Practice Address - Phone:802-255-5520
Practice Address - Fax:802-255-5529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006168Medicaid