Provider Demographics
NPI:1437694635
Name:NDA ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:NDA ASSOCIATES, PLLC
Other - Org Name:TMJ, SLEEP THERAPY & AIRWAY ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:802-876-7803
Mailing Address - Street 1:71 KNIGHT LN
Mailing Address - Street 2:SUITE 10
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-4432
Mailing Address - Country:US
Mailing Address - Phone:802-876-7803
Mailing Address - Fax:
Practice Address - Street 1:71 KNIGHT LN
Practice Address - Street 2:SUITE 10
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-4432
Practice Address - Country:US
Practice Address - Phone:802-876-7803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.01172421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty