Provider Demographics
NPI:1346351046
Name:DALLESKE, RONALD L (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:DALLESKE
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 1:4379 GEVALIA DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34604-5806
Mailing Address - Country:US
Mailing Address - Phone:352-754-1403
Mailing Address - Fax:
Practice Address - Street 1:3429 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2463
Practice Address - Country:US
Practice Address - Phone:352-666-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN59871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice