Individual
DR. PAUL FRANCIS KENWORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 KENNEDY DR # LL4, SOUTH BURLINGTON, VT 05403-7152
(888) 720-5832
(888) 965-5114
Mailing address
1 KENNEDY DR # LL4, SOUTH BURLINGTON, VT 05403-7152
(888) 720-5832
(888) 965-5114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016-0000975
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002551
—
VT
01
—
Y400189729
MEDICARE ID # ASSOCIATED WITH A REASSIGNMENT OF BENEFITS
VT
Enumeration date
04/30/2006
Last updated
03/17/2018
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