DR. KENNETH J. STAVISKY LTD. NPI 1942384979

NPI Information

DR. KENNETH J. STAVISKY, LTD. is an endodontics dentist in South Burlington, VT. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. DR. KENNETH J. STAVISKY, LTD. NPI is 1942384979. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

99 SWIFT ST
SUITE 115
SOUTH BURLINGTON, VT
ZIP 05403-303
Phone: (802) 865-1212
Fax: (802) 865-4666

The provider's authorized official is Martha Whitcomb Philbrick .
The authorized official title is Office Manager and has the following contact phone number (802) 865-1212.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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