Provider Demographics
NPI:1437345543
Name:STANTON, KEVIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:STANTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PARK LANE RD
Mailing Address - Street 2:UNIT B201
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2444
Mailing Address - Country:US
Mailing Address - Phone:860-350-9232
Mailing Address - Fax:860-355-9232
Practice Address - Street 1:120 PARK LANE RD
Practice Address - Street 2:UNIT B201
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2444
Practice Address - Country:US
Practice Address - Phone:860-350-9232
Practice Address - Fax:860-355-9232
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0098251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice