Provider Demographics
NPI:1104229475
Name:CVOMS ASSOCIATES, PC
Entity type:Organization
Organization Name:CVOMS ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:IV
Authorized Official - Credentials:DDS
Authorized Official - Phone:802-862-9196
Mailing Address - Street 1:441 WATERTOWER CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5801
Mailing Address - Country:US
Mailing Address - Phone:802-862-9196
Mailing Address - Fax:802-862-5769
Practice Address - Street 1:441 WATERTOWER CIR STE 100
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5801
Practice Address - Country:US
Practice Address - Phone:802-862-9196
Practice Address - Fax:802-862-5769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.00848091223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty