Provider Demographics
NPI:1538395280
Name:BANNISTER, SHEILA CATHERINE (RDH)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:CATHERINE
Last Name:BANNISTER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WALLACE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05663-6936
Mailing Address - Country:US
Mailing Address - Phone:802-879-2315
Mailing Address - Fax:802-879-2317
Practice Address - Street 1:301 LAWRENCE PL
Practice Address - Street 2:DEPARTMENT OF DENTAL HYGIENE
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-7167
Practice Address - Country:US
Practice Address - Phone:802-879-2315
Practice Address - Fax:802-879-2317
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT015-0001355124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist