Provider Demographics
NPI:1801839014
Name:PROFESSIONAL DENTAL CARE, PLLC.
Entity Type:Organization
Organization Name:PROFESSIONAL DENTAL CARE, PLLC.
Other - Org Name:PROFESSIONAL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GIORDANO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-492-2440
Mailing Address - Street 1:72 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301
Mailing Address - Country:US
Mailing Address - Phone:802-254-9644
Mailing Address - Fax:802-257-8512
Practice Address - Street 1:72 HIGH STREET
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301
Practice Address - Country:US
Practice Address - Phone:802-254-9644
Practice Address - Fax:802-257-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0160000888122300000X
VT0160001173122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty