Healthcare Provider Details

I. General information

NPI: 1730104712
Provider Name (Legal Business Name): RONALD D WARREN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 EDGEWOOD DR
TRENTON OH
45067-0047
US

IV. Provider business mailing address

PO BOX 47 300 EDGEWOOD DRIVE
TRENTON OH
45067
US

V. Phone/Fax

Practice location:
  • Phone: 513-988-5000
  • Fax: 513-988-5001
Mailing address:
  • Phone: 513-988-5000
  • Fax: 513-988-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number31-7175
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: