Provider Demographics
NPI:1346447778
Name:SORETH, RONALD MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MICHAEL
Last Name:SORETH
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 1:706 FAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1761
Mailing Address - Country:US
Mailing Address - Phone:610-828-4034
Mailing Address - Fax:610-828-8450
Practice Address - Street 1:706 FAYETTE ST
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1761
Practice Address - Country:US
Practice Address - Phone:610-828-4034
Practice Address - Fax:610-828-8450
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-022675-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice