Provider Demographics
NPI:1982769923
Name:STRAIGHT, DENNIS HENRY (BSRPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:HENRY
Last Name:STRAIGHT
Suffix:
Gender:M
Credentials:BSRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 672
Mailing Address - Street 2:
Mailing Address - City:WELLS RIVER
Mailing Address - State:VT
Mailing Address - Zip Code:05081-0672
Mailing Address - Country:US
Mailing Address - Phone:802-757-2244
Mailing Address - Fax:
Practice Address - Street 1:41 MAIN ST NORTH
Practice Address - Street 2:
Practice Address - City:WELLS RIVER
Practice Address - State:VT
Practice Address - Zip Code:05081-0672
Practice Address - Country:US
Practice Address - Phone:802-757-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0330002410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist