David Don Hassebroek, DDS

Individual provider Active NPI General Practice Dentistry · Castleton, VT

NPI 1265572010 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1265572010
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
917 (VT)
Practice address
RT. 30 Castleton Four Corners
Castleton, VT 05735-0417
Phone
(802) 468-5478
Fax
(802) 468-3261
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
917VTMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 917 VT Yes

Addresses

Primary practice location

RT. 30 Castleton Four Corners
Castleton, VT 05735-0417

Mailing address

PO Box 417
Castleton, VT 05735-0417
Phone (802) 468-5478

Other providers in Castleton, VT

All providers in Castleton, VT · General Practice Dentistry in Vermont

Sources for this page

Verify at the official NPI Registry.