Individual
COLLIN KWASNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
395 PAINE TPKE N, BERLIN, VT 05602-9157
(802) 229-0561
Mailing address
1511 COX BROOK RD, NORTHFIELD, VT 05663-6614
(802) 272-4498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016.0133962
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
VT
Other
Enumeration date
03/26/2020
Last updated
11/09/2021
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