Provider Demographics
NPI:1649917550
Name:STRATTON, KENDRA ELIZABETH (DH)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:ELIZABETH
Last Name:STRATTON
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 ROLLIN ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-2648
Mailing Address - Country:US
Mailing Address - Phone:802-688-6652
Mailing Address - Fax:
Practice Address - Street 1:747 EAST RD
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-4488
Practice Address - Country:US
Practice Address - Phone:802-447-7541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT015.0001303124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist