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General NPI Number Information
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NPI Number | 1386867372
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Entity Type | Organization
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Legal Business Name | RONALD TROSPER DDS INC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 145 AVENIDA DEL MAR
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City | SAN CLEMENTE
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State | CA
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Zip | 92672
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Country | US
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Telephone | 949-492-7140
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Fax | 949-492-2972
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Provider Business Mailing Address
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Address Line | 145 AVENIDA DEL MAR
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City | SAN CLEMENTE
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State | CA
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Zip | 92672
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Country | US
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Telephone | 949-492-7140
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Fax | 949-492-2972
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD WINSTON TROSPER
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Credential | DDS
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Telephone | 949-492-7140
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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 | 20478
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License Number State | CA
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