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General NPI Number Information
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NPI Number | 1447267083
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Entity Type | Individual
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Provider Name | KATERYNA LATYPOVA DMD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 160 BENMONT AVE SUITE 21
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City | BENNINGTON
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State | VT
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Zip | 05201
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Country | US
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Telephone | 802-447-3199
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Fax | 802-447-3123
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Provider Business Mailing Address
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Address Line | 160 BENMONT AVE SUITE 21
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City | BENNINGTON
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State | VT
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Zip | 05201
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Country | US
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Telephone | 802-447-3199
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Fax | 802-447-3123
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 04805
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 20675
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2284
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License Number State | VT
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