Provider Demographics
NPI:1740306224
Name:ASSOCIATES IN ORHTODONTICS PC
Entity type:Organization
Organization Name:ASSOCIATES IN ORHTODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ANGUS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MSD
Authorized Official - Phone:802-859-9441
Mailing Address - Street 1:1 KENNEDY DRIVE
Mailing Address - Street 2:SUITE #5
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403
Mailing Address - Country:US
Mailing Address - Phone:802-859-9441
Mailing Address - Fax:802-862-2424
Practice Address - Street 1:1 KENNEDY DRIVE
Practice Address - Street 2:SUITE #5
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-859-9441
Practice Address - Fax:802-862-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006324Medicaid