Organization
SOUTHERN VERMONT ENDONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERYL LANG ULLMAN DMD (PRESIDENT)
(802) 773-7767
Entity
Organization
Contact information
Practice address
71 ALLEN ST, SUITE 204, RUTLAND, VT 05701-4570
(802) 773-7767
(802) 775-7667
Mailing address
PO BOX 130, RUTLAND, VT 05702-0130
(802) 773-9715
(802) 775-7667
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1124
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009354
—
VT
Enumeration date
04/04/2007
Last updated
08/22/2020
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