Provider Demographics
NPI:1285206870
Name:STOWE DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:STOWE DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTADONNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:802-253-7932
Mailing Address - Street 1:PO BOX 1543
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-1543
Mailing Address - Country:US
Mailing Address - Phone:802-253-7932
Mailing Address - Fax:802-253-6220
Practice Address - Street 1:32 MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-1543
Practice Address - Country:US
Practice Address - Phone:802-253-7932
Practice Address - Fax:802-253-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental