Provider Demographics
NPI:1053508507
Name:VANSLOOTEN, RONALD HENRY (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:HENRY
Last Name:VANSLOOTEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WARREN AVENUE
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423
Mailing Address - Country:US
Mailing Address - Phone:201-447-1116
Mailing Address - Fax:201-493-9115
Practice Address - Street 1:110 WARREN AVENUE
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423
Practice Address - Country:US
Practice Address - Phone:201-447-1116
Practice Address - Fax:201-493-9115
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ220100759200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist