Provider Demographics
NPI:1467845446
Name:RONALD J LEVINE DMD PC
Entity Type:Organization
Organization Name:RONALD J LEVINE DMD PC
Other - Org Name:WILLAMETTE VALLEY PROSTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-686-2443
Mailing Address - Street 1:244 B COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2200
Mailing Address - Country:US
Mailing Address - Phone:541-686-2443
Mailing Address - Fax:541-302-0763
Practice Address - Street 1:244 B COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2200
Practice Address - Country:US
Practice Address - Phone:541-686-2443
Practice Address - Fax:541-302-0763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-14
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty