Provider Demographics
NPI:1225549652
Name:BARRE DENTISRY & IMPLANTS, PLC
Entity Type:Organization
Organization Name:BARRE DENTISRY & IMPLANTS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAN
Authorized Official - Middle Name:U
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:802-476-3171
Mailing Address - Street 1:20 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-3424
Mailing Address - Country:US
Mailing Address - Phone:802-476-3171
Mailing Address - Fax:802-476-8788
Practice Address - Street 1:20 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-3424
Practice Address - Country:US
Practice Address - Phone:802-476-3171
Practice Address - Fax:802-476-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.0002213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT016.0002213OtherBOARD OF DENTAL EXAMINERS
VT1012294Medicaid