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General NPI Number Information
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NPI Number | 1346351046
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Entity Type | Individual
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Provider Name | RONALD L DALLESKE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 3429 MARINER BLVD
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City | SPRING HILL
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State | FL
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Zip | 34609-2463
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Country | US
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Telephone | 352-666-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 4379 GEVALIA DR
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City | BROOKSVILLE
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State | FL
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Zip | 34604-5806
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Country | US
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Telephone | 352-754-1403
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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 | DN5987
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License Number State | FL
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