Provider Demographics
NPI:1053473207
Name:SCHWEITZER, KENNETH M (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:M
Last Name:SCHWEITZER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05762-0544
Mailing Address - Country:US
Mailing Address - Phone:802-746-8390
Mailing Address - Fax:718-515-5419
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-2381
Practice Address - Fax:718-515-5419
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0400701223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics