Individual
MICHAEL THOMAS KENTOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4408 U.S. ROUTE 5, DERBY, VT 05829
(802) 334-2313
Mailing address
294 COVENTRY ST APT 4, NEWPORT, VT 05855-1973
(802) 487-9048
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
033.0096331
VT
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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