MEDICARE: DR. RONALD CLEVE HOUSE DDS, MS

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	3340	WV

General Provider Information

NPI Number	:	1851330377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD CLEVE HOUSE DDS, MS

Provider Business Mailing Address
First Line	:	33 MAPLE AVE
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26501-6572
Country	:	US
Telephone Number	:	304-296-4774
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 HEALTH SCIENCES NORTH
Second Line	:	ROOM 1056
City	:	MORGANTOWN
State	:	WV
Zip	:	26506-9460
Country	:	US
Telephone Number	:	304-293-1142
Fax Number	:

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/08/2007

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