NPI 1912100256

Maple Leaf Family Dentistry

Organisation General Practice Dentistry Morrisville, VT

Practice location

Address: 58 Brigham Street, Morrisville, VT 05661
Phone: (802) 888-5685
Mailing address: PO Box 636, Morrisville, VT 05661-0636

Authorised official

Name: Matthew S Ebert
Title: Owner
Phone: (802) 888-5685

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 016-0002038 (VT)

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Registry record

NPI: 1912100256
Entity type: Organization
NPI issued: 6 Jun 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.