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General NPI Number Information
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NPI Number | 1598869075
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Entity Type | Individual
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Provider Name | RONALD KEITH DEDMOND D.D.S.,P.A.
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 301 S ACADEMY ST
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City | LINCOLNTON
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State | NC
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Zip | 28092-2716
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Country | US
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Telephone | 704-735-7001
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Fax | 704-735-7654
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Provider Business Mailing Address
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Address Line | 101 WOODVALE CIR
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City | LINCOLNTON
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State | NC
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Zip | 28092-7712
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Country | US
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Telephone | 704-735-2963
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 4049
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License Number State | NC
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