Provider Demographics
NPI:1033247671
Name:SCONYERS, RONALD COLEMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:COLEMAN
Last Name:SCONYERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FANT ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4825
Mailing Address - Country:US
Mailing Address - Phone:864-226-8040
Mailing Address - Fax:864-225-9965
Practice Address - Street 1:1411 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4825
Practice Address - Country:US
Practice Address - Phone:864-226-8040
Practice Address - Fax:864-225-9965
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX3267Medicaid