Provider Demographics
NPI:1164421996
Name:CASS, RONALD B (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:B
Last Name:CASS
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 HART LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3018
Mailing Address - Country:US
Mailing Address - Phone:512-345-2655
Mailing Address - Fax:512-345-2658
Practice Address - Street 1:7011 HART LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3018
Practice Address - Country:US
Practice Address - Phone:512-345-2655
Practice Address - Fax:512-345-2658
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-08-07
Provider Licenses
StateLicense IDTaxonomies
TX98941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice