Provider Demographics
NPI:1073643243
Name:DAYMON, RONALD LEWITT (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LEWITT
Last Name:DAYMON
Suffix:
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 1:1295 PORTLAND AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2731
Mailing Address - Country:US
Mailing Address - Phone:585-342-8050
Mailing Address - Fax:585-342-9024
Practice Address - Street 1:1295 PORTLAND AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2731
Practice Address - Country:US
Practice Address - Phone:585-342-8050
Practice Address - Fax:585-342-9024
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0465981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice