Provider Demographics
NPI:1033224894
Name:NASON, RONALD H JR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:H
Last Name:NASON
Suffix:JR
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E GARRISON BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-5139
Mailing Address - Country:US
Mailing Address - Phone:704-866-8281
Mailing Address - Fax:704-866-8489
Practice Address - Street 1:1601 E GARRISON BLVD STE D
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5139
Practice Address - Country:US
Practice Address - Phone:704-866-8281
Practice Address - Fax:704-866-8489
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC61601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU57686Medicare UPIN