MEDICARE: RONALD N COLE DMD PC

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		IL

General Provider Information

NPI Number	:	1447304738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD N COLE DMD PC

Provider Business Mailing Address
First Line	:	2727 N OAKLAND AVE
Second Line	:	SUITE 103
City	:	DECATUR
State	:	IL
Zip	:	62526-1586
Country	:	US
Telephone Number	:	217-875-4505
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 N OAKLAND AVE
Second Line	:	SUITES 101 AND 103
City	:	DECATUR
State	:	IL
Zip	:	62526-1586
Country	:	US
Telephone Number	:	217-875-4505
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RONALD N COLE
Credential	:	D.M.D.
Telephone Number	:	217-875-4505

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

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