IndividualActive
Adisa Ratanasirintrawoot
NPI 1619443546 · Periodontics · South Burlington, VT
Provider details
- NPI number
- 1619443546
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 016.0134058 (VT)
Specialties & taxonomies
Dental Providers
Practice location
1775 Williston Rd
South Burlington, VT 05403-6491
Phone: (802) 863-5447
Approximate (ZIP-level) locationGet directions
Mailing address
77 Pine St Apt 509
Burlington, VT 05401-5945
Registry dates
- Enumerated
- 2018-10-18
- Last updated
- 2021-09-28
- Certified
- 2021-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.