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General NPI Number Information
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NPI Number | 1053539338
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Entity Type | Organization
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Legal Business Name | RONALD K. RISINGER, DDS, MS, PC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 7900 MEDICAL CENTER BLVD
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City | PORT ARTHUR
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State | TX
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Zip | 77640-2425
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Country | US
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Telephone | 409-729-2371
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Fax | 409-729-2729
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Provider Business Mailing Address
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Address Line | 7900 MEDICAL CENTER BLVD
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City | PORT ARTHUR
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State | TX
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Zip | 77640-2425
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Country | US
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Telephone | 409-729-2371
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Fax | 409-729-2729
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. RONALD KEITH RISINGER
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Credential | DDS, MS
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Telephone | 409-729-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 15661
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License Number State | TX
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