Provider Demographics
NPI:1437316163
Name:RONALD M. SLOAN, D.D.S., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RONALD M. SLOAN, D.D.S., A PROFESSIONAL CORPORATION
Other - Org Name:RONALD M. SLOAN, D.D.S.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-286-9995
Mailing Address - Street 1:350 S BEVERLY DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4811
Mailing Address - Country:US
Mailing Address - Phone:310-286-9995
Mailing Address - Fax:
Practice Address - Street 1:350 S BEVERLY DR
Practice Address - Street 2:SUITE 180
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4811
Practice Address - Country:US
Practice Address - Phone:310-286-9995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty