Provider Demographics
NPI:1144387481
Name:RENDE, RONALD LOUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LOUIS
Last Name:RENDE
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 1:18540 W OUTER DR STE # 1
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1896
Mailing Address - Country:US
Mailing Address - Phone:313-562-1225
Mailing Address - Fax:313-562-4895
Practice Address - Street 1:18540 W OUTER DR STE # 1
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1896
Practice Address - Country:US
Practice Address - Phone:313-562-1225
Practice Address - Fax:313-562-4895
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI85061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice