Provider Demographics
NPI:1346379112
Name:RONCIN, RAYMOND FRED JR (DMD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:FRED
Last Name:RONCIN
Suffix:JR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:20 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6434
Mailing Address - Country:US
Mailing Address - Phone:732-341-7800
Mailing Address - Fax:732-341-7882
Practice Address - Street 1:20 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 11
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6434
Practice Address - Country:US
Practice Address - Phone:732-341-7800
Practice Address - Fax:732-341-7882
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJNJ016346122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice