Breen, Gary H
Breen, Gary H is an sole proprietor health care provider with primary practice located at 50 Mahoney Ave , Rutland VT 05701-4836. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Breen, Gary H can be contacted via phone (802) 775-6771.Contact Information
Primary practice address
50 Mahoney Ave
Rutland VT 05701-4836
Phone: (802) 775-6771
Fax: (802) 775-3116
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 620 | Vermont |
Profile Details
| NPI number | 1215039375 |
|---|---|
| LBN Legal business name | Breen, Gary H |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215039375 | NPPES |
| Vermont | MEDICAID | 0002413 |
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