Provider Demographics
NPI:1235306994
Name:AMES, RONALD P (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:P
Last Name:AMES
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 1:904 E HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-2813
Mailing Address - Country:US
Mailing Address - Phone:618-632-8471
Mailing Address - Fax:618-632-7130
Practice Address - Street 1:904 E HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-2813
Practice Address - Country:US
Practice Address - Phone:618-632-8471
Practice Address - Fax:618-632-7130
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190225851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice