Provider Demographics
NPI:1033246368
Name:GEORGE V. RANTA, D.D. S., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GEORGE V. RANTA, D.D. S., A PROFESSIONAL CORPORATION
Other - Org Name:ROCKY MOUNTAIN CENTER FOR RESTORATIVE AND IMPLANT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:V
Authorized Official - Last Name:RANTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-392-4231
Mailing Address - Street 1:6980 MESA RIDGE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-1563
Mailing Address - Country:US
Mailing Address - Phone:719-392-4231
Mailing Address - Fax:719-392-9096
Practice Address - Street 1:6980 MESA RIDGE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-1563
Practice Address - Country:US
Practice Address - Phone:719-392-4231
Practice Address - Fax:719-392-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty