| NPI | 1780196329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL FRANCIS KENWORTHY Dentist/Owner 802-238-7249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |