Provider Demographics
NPI:1831935410
Name:VERMONT FAMILY DENTAL PLC
Entity type:Organization
Organization Name:VERMONT FAMILY DENTAL PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JP
Authorized Official - Middle Name:
Authorized Official - Last Name:RABBATH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:802-524-9774
Mailing Address - Street 1:39 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-1610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-1610
Practice Address - Country:US
Practice Address - Phone:802-524-9774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VERMONT FAMILY DENTAL PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental