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General NPI Number Information
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NPI Number | 1134380355
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Entity Type | Individual
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Provider Name | RONNIE GEORGE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 111 BATA BLVD STE D
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City | BELCAMP
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State | MD
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Zip | 21017-1427
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Country | US
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Telephone | 410-272-1536
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Fax |
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Provider Business Mailing Address
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Address Line | 106 W UNIVERSITY PKWY APT # L1
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City | BALTIMORE
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State | MD
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Zip | 21210-3432
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Country | US
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Telephone | 919-608-9189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14187
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License Number State | MD
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