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Dr. Suthanya Srisuro, DDS,MS
Orthodontics and Dentofacial Orthopedic Dentist in Godfrey, Illinois
NPI 1982829289

Suthanya Srisuro is a Orthodontics and Dentofacial Orthopedic Dentist based in Saint Louis, IL and is specialized in Orthodontics and Dentofacial Orthopedics. Suthanya Srisuro practices in Godfrey, IL and has the professional credentials of DDS,MS. The NPI Number for Suthanya Srisuro is 1982829289 and holds a License No. 21000857 (Illinois).

The current practice location address for Suthanya Srisuro is 3011 Godfrey Rd, Godfrey, IL and can be reached out via phone at 618-466-7966.

Location: 3011 Godfrey Rd, Godfrey, IL, 63131-3428
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982829289
Provider Name
Suthanya Srisuro
Credential
DDS,MS
Provider Entity Type
Individual
Gender
Female
Address
3011 Godfrey Rd, Godfrey, IL, 63131-3428
Phone Number
618-466-7966
Fax Number
Provider Enumeration Date
04/13/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1003841 05 IL
UNITED CONCORDIA 01 IL PPO NETWORK
227188 01 IL CIGNA HMO
institution
Provider Business Practice Location Address Details
Address
3011 Godfrey Rd
City
Godfrey
State
Illinois
Zip
62035-1808
Phone Number
618-466-7966
Fax Number
person
Provider Business Mailing Address Details
Address
3011 Godfrey Rd
City
Godfrey
State
Illinois
Zip
62035-1808
Phone Number
618-466-7966
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Orthodontics and Dentofacial Orthopedics
Taxonomy
1223X0400X
License No.
21000857 (Illinois)
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
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