Provider Demographics
NPI:1245275122
Name:STOWE FAMILY DENTISTRY PC
Entity type:Organization
Organization Name:STOWE FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HIRCE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:802-253-4157
Mailing Address - Street 1:1593 PUCKER ST
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-4579
Mailing Address - Country:US
Mailing Address - Phone:802-253-4157
Mailing Address - Fax:802-253-7025
Practice Address - Street 1:1593 PUCKER ST
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4579
Practice Address - Country:US
Practice Address - Phone:802-253-4157
Practice Address - Fax:802-253-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT4801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty