Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SUTHANYA SRISURO, D.D.S., M.S.
Active Sole ProprietorDR. SUTHANYA SRISURO, D.D.S., M.S. is a Orthodontics healthcare provider located in GODFREY, Illinois. NPI 1982829289 is currently active in the NPPES registry. Verify at CMS.
Orthodontics · GODFREY, IL
Registration Details
- NPI Number
- 1982829289
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 13, 2007 (19.301252542235 yrs)
- Last Updated
- Jul 9, 2007
- License
-
21000857 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3011 GODFREY RDGODFREY, IL, 620351808Browse IL providers · Browse ZIP 62035
- Phone
- 6184667966
- Primary Specialty
-
Orthodontics
1223X0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.