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General NPI Number Information
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NPI Number | 1245286095
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Entity Type | Individual
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Provider Name | RONALD RICHARD TILGNER DDS
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 109 STONEY POINTE DR
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City | HOLLISTER
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State | MO
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Zip | 65672-4101
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Country | US
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Telephone | 814-558-7129
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Fax |
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Provider Business Mailing Address
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Address Line | 109 STONEY POINTE DR
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City | HOLLISTER
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State | MO
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Zip | 65672-4101
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Country | US
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Telephone | 814-558-7129
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 3380
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | DEN-DEN-LIC- 11602
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS022410L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2024004291
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License Number State | MO
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