Provider Demographics
NPI:1730186909
Name:NEUMEISTER, DAVID R (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:NEUMEISTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 HUCKLEHILL RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:VT
Mailing Address - Zip Code:05354-9594
Mailing Address - Country:US
Mailing Address - Phone:802-254-2077
Mailing Address - Fax:
Practice Address - Street 1:1046 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7144
Practice Address - Country:US
Practice Address - Phone:802-254-2384
Practice Address - Fax:802-254-5717
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT4721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0001769Medicaid