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General NPI Number Information
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NPI Number | 1558334060
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Entity Type | Organization
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Legal Business Name | RONALD K. EWERT, DDS, PC
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 750 N 14TH ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4150
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Country | US
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Telephone | 541-741-2252
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Fax | 541-741-7390
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Provider Business Mailing Address
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Address Line | 750 N 14TH ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4150
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Country | US
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Telephone | 541-741-2252
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Fax | 541-741-7390
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. RONALD KEITH EWERT
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Credential | DDS
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Telephone | 541-741-2252
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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 | D7190
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License Number State | OR
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