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General NPI Number Information
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NPI Number | 1750724084
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Entity Type | Organization
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Legal Business Name | DR, VICTOR L. RATKUS, DDS, PC
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 227 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1411
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Country | US
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Telephone | 802-864-0461
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Fax | 802-864-0201
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Provider Business Mailing Address
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Address Line | 227 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1411
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Country | US
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Telephone | 802-864-0461
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Fax | 802-864-0201
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICTOR L RATKUS
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Credential | DDS
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Telephone | 802-355-9952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | VT-0529
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License Number State | VT
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