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General NPI Number Information
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NPI Number | 1285824565
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Entity Type | Individual
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Provider Name | VERUTZKA N SOZA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 100 W WALNUT AVE STE 142
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City | DALTON
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State | GA
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Zip | 30720-8440
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Country | US
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Telephone | 706-529-8427
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Fax |
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Provider Business Mailing Address
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Address Line | 125 SCOTT ST
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City | DAVENPORT
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State | IA
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Zip | 52801-1130
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Country | US
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Telephone | 563-336-3221
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Fax | 563-336-3229
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN013956
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 08503
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License Number State | IA
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