Provider Demographics
NPI:1174533327
Name:SCHRAMM AND SYMANCYK, PLLC
Entity type:Organization
Organization Name:SCHRAMM AND SYMANCYK, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO OWNER GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:802-295-2458
Mailing Address - Street 1:PO BOX 948
Mailing Address - Street 2:
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-0948
Mailing Address - Country:US
Mailing Address - Phone:802-295-2458
Mailing Address - Fax:802-295-3985
Practice Address - Street 1:1049 NORTH HARTLAND ROAD
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001
Practice Address - Country:US
Practice Address - Phone:802-295-2458
Practice Address - Fax:802-295-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT6251223G0001X
VT106.0086114122300000X
VTVT10281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0001901Medicaid
VT1002992Medicaid
VT1014988Medicaid
VT1028Medicaid
VT625Medicaid