Provider Demographics
NPI:1467773754
Name:B. RONALD ROMMEL, DDS, PC
Entity Type:Organization
Organization Name:B. RONALD ROMMEL, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:ROMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-455-1200
Mailing Address - Street 1:5601 NE ANTIOCH RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2300
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:SUITE 5
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119-2300
Practice Address - Country:US
Practice Address - Phone:816-455-1200
Practice Address - Fax:816-455-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO124631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty