# SOUTHERN VERMONT ENDONTICS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558483321
- **Authorized official:** DR. CHERYL LANG ULLMAN DMD (PRESIDENT)
- **Authorized official phone:** (802) 773-7767

## Contact information

- **Practice address:** 71 ALLEN ST, SUITE 204, RUTLAND, VT 05701-4570
- **Practice address phone:** (802) 773-7767
- **Practice address fax:** (802) 775-7667
- **Mailing address:** PO BOX 130, RUTLAND, VT 05702-0130
- **Mailing address phone:** (802) 773-9715
- **Mailing address fax:** (802) 775-7667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 1124 | VT | Yes |

## Other

- **Enumeration date:** 04/04/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1009354 | — | VT |