Provider Demographics
NPI:1275764631
Name:PALIT, SONYA RONJONA (DDS)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:RONJONA
Last Name:PALIT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 ROBINSON RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1742
Mailing Address - Country:US
Mailing Address - Phone:616-581-1423
Mailing Address - Fax:
Practice Address - Street 1:5278 KALAMAZOO AVE SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-6131
Practice Address - Country:US
Practice Address - Phone:616-531-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0180017251223G0001X
MI29010231891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice