MEDICARE: DR. RONALD ALLEN VANTUYL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3082	OK

General Provider Information

NPI Number	:	1437296118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD ALLEN VANTUYL D.D.S.

Provider Business Mailing Address
First Line	:	3223 E 31ST ST
Second Line	:	SUITE 108
City	:	TULSA
State	:	OK
Zip	:	74105-2452
Country	:	US
Telephone Number	:	918-743-9946
Fax Number	:	918-742-1021

Provider Business Practice Location Address
First Line	:	3223 E 31ST ST
Second Line	:	SUITE 108
City	:	TULSA
State	:	OK
Zip	:	74105-2452
Country	:	US
Telephone Number	:	918-743-9946
Fax Number	:	918-742-1021

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	01/25/2026

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