Provider Demographics
NPI:1932363041
Name:ORAL AND FACIAL SURGERY ASSOCIATES,PLC
Entity type:Organization
Organization Name:ORAL AND FACIAL SURGERY ASSOCIATES,PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHSCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-664-4100
Mailing Address - Street 1:2 HARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-2323
Mailing Address - Country:US
Mailing Address - Phone:802-447-7073
Mailing Address - Fax:802-442-2725
Practice Address - Street 1:2 HARWOOD DR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2323
Practice Address - Country:US
Practice Address - Phone:802-447-7073
Practice Address - Fax:802-442-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9721533Medicaid
VT1008284Medicaid
MAX10718Medicare PIN
VTVN2787Medicare PIN