MALLETT'S BAY DENTISTRY (NPI# 1477851723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477851723 |
| Entity Type | Organization |
| Organization Name | MALLETT'S BAY DENTISTRY |
| Practice Address |
97 Blakely Rd Suite 104 Colchester VT 05446-4008 |
| Practice Telephone | 8028628266 |
| Practice Fax Number | 8028626416 |
| Mailing Telephone | 8028628266 |
| Mailing Fax Number | 8028626416 |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |
| Authorized Official Name | DR. DENHAM B. CRAFTON II (CEO) |
| Authorized Official Telephone | 8028628266 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CRAFTON FAMILY DENTISTRY, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
016-0002281 | VT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1015584 | 05 |
| Street Address |
97 BLAKELY RD SUITE 104 |
| City | COLCHESTER |
| State | VT |
| Zip Code | 05446-4008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942237375 | John A Cross | Dentist | 97 Blakely Rd, Suite 104, Colchester, VT 05446-4008 | 2006-06-28 |
| 1508191651 | Crafton Family Dentistry Pllc | Dentist | 97 Blakely Rd, Suite 104, Colchester, VT 05446-4008 | 2009-10-07 |
| 1245443373 | Denham B. Crafton II | Dentist | 97 Blakely Rd, Colchester, VT 05446-4008 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174130157 | Justin Michael Boufford | Pharmacist | 218 Lower Mountian View Dr., Colchester, VT 05446 | 2020-09-24 |
| 1174154991 | The Vermont Center for Responder Wellness | Social Worker | 162 Hegeman Avenue, Suite 100, Colchester, VT 05446 | 2020-01-30 |
| 1972011047 | Erin Lee Murphy | Speech-Language Pathologist | 131 Laker Lane, Colchester, VT 05446 | 2018-01-11 |
| 1821535204 | Zoe Walsh | Specialist/Technologist | 131 Laker Ln, Colchester, VT 05446 | 2017-01-24 |
| 1407262827 | Charlotte M Church | Dentist | 416 Roosevelt Hwy Ste 201, Colchester, VT 05446 | 2014-07-07 |
| 1215251681 | Courtney Joy Brink | Speech-Language Pathologist | 1100 Prim Rd, Colchester, VT 05446 | 2010-03-15 |
| 1316170343 | Alexis Brooke Ressler | Nurse Practitioner | 729 Colchester Parkway, Medical Office Building, Suite 205, Colchester, VT 05446 | 2009-08-25 |
| 1659539393 | Deborah Kalamasz | Speech-Language Pathologist | 11102 Ethan Allen Ave, Colchester, VT 05446 | 2008-05-29 |
| 1235356700 | Angelo Marinakis | Chiropractor | 85 Prim Road, Suite 401, Colchester, VT 05446 | 2007-04-19 |
| 1629292719 | Susan Mary Coleman | Occupational Therapist | 800 Middle Road, Colchester, VT 05446 | 2007-04-12 |
| Find all providers in zip 05446 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386116895 | Golden Colchester Pllc | Clinic/Center | 416 Roosevelt Hwy, Colchester, VT 05446-5975 | 2018-12-21 |
| 1679786842 | Alpine Family Dental LLC | Clinic/Center | 875 Roosevelt Hwy, Suite 110, Colchester, VT 05446-4460 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801459680 | Northeast Kingdom Dental Group Pllc | Clinic/Center | 49 W Church St, Hardwick, VT 05843-6001 | 2019-04-17 |
| 1013410331 | Rutland Family Dental, Plc | Clinic/Center | 240 Stratton Rd Ste 2, Rutland, VT 05701-4623 | 2018-03-13 |
| 1780886978 | Montpelier Dental Group | Clinic/Center | 4 Spring St Ste 1, Montpelier, VT 05602-2224 | 2007-06-01 |
| 1356350565 | Affordable Dentures Burlington PC | Clinic/Center | 1162 Williston Road, South Burlington, VT 05403 | 2006-08-05 |
| 1649236225 | Northern Counties Health Care Inc | Clinic/Center | 165 Sherman Dr, St Johnsbury, VT 05819-9811 | 2006-04-24 |
| 1366901464 | United Way of Windham County | Clinic/Center | 375 Canal St, Brattleboro, VT 05301-6936 | 2019-03-18 |
| 1588139463 | Brandon Vanasse Dmd Pllc | Clinic/Center | 296 Main Street, Derby, VT 05829 | 2018-10-08 |
| 1770064388 | Brandon Family Dentistry | Clinic/Center | 5 Carver St, Brandon, VT 05733-1103 | 2018-08-22 |
| 1861970006 | Stratton Dental Arts | Clinic/Center | 163 Stratton Rd, Rutland, VT 05701-4619 | 2018-07-31 |
| 1285127621 | David L Stanley Dmd Pllc | Clinic/Center | 34 Mapleville Depot, Saint Albans, VT 05478-1857 | 2018-06-11 |
| Find all providers with the same taxonomy | ||||
| City | COLCHESTER |
| Zip Code | 05446 |
Please comment or provide details below to improve the information on MALLETT'S BAY DENTISTRY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.