Healthcare Provider Details

I. General information

NPI: 1336163146
Provider Name (Legal Business Name): RONALD HARVEY SCHERICK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 SOMERS RD BOX 305
ELLINGTON CT
06029-3424
US

IV. Provider business mailing address

238 SOMERS RD BOX305
ELLINGTON CT
06029-3424
US

V. Phone/Fax

Practice location:
  • Phone: 860-875-1372
  • Fax:
Mailing address:
  • Phone: 860-875-1372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4679
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: