Healthcare Provider Details

I. General information

NPI: 1194949198
Provider Name (Legal Business Name): RONALD C STRATTON JR. D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N HOOD ST STE B
LAKE PROVIDENCE LA
71254-2103
US

IV. Provider business mailing address

100 LAKEPOINT CIR
WEST MONROE LA
71291-9044
US

V. Phone/Fax

Practice location:
  • Phone: 318-559-0134
  • Fax:
Mailing address:
  • Phone: 318-396-9838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4455
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: