Healthcare Provider Details

I. General information

NPI: 1750724084
Provider Name (Legal Business Name): DR, VICTOR L. RATKUS, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 COLCHESTER AVE
BURLINGTON VT
05401-1411
US

IV. Provider business mailing address

227 COLCHESTER AVE
BURLINGTON VT
05401-1411
US

V. Phone/Fax

Practice location:
  • Phone: 802-864-0461
  • Fax: 802-864-0201
Mailing address:
  • Phone: 802-864-0461
  • Fax: 802-864-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberVT-0529
License Number StateVT

VIII. Authorized Official

Name: DR. VICTOR L RATKUS
Title or Position: OWNER
Credential: DDS
Phone: 802-355-9952