Provider Demographics
NPI:1396817441
Name:ROMMEL, BILLY RONALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:RONALD
Last Name:ROMMEL
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 1:5601 NE ANTIOCH RD
Mailing Address - Street 2:STE 5
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2302
Mailing Address - Country:US
Mailing Address - Phone:816-455-1200
Mailing Address - Fax:816-455-1021
Practice Address - Street 1:5601 NE ANTIOCH RD
Practice Address - Street 2:STE 5
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119-2302
Practice Address - Country:US
Practice Address - Phone:816-455-1200
Practice Address - Fax:816-455-1021
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO124631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice