| NPI | 1285012401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL KENWORTHY Owner/Dentist 802-879-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: VT 975) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-10-26 |