Provider Demographics
NPI:1477625333
Name:FROST, RONALD E (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:FROST
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 1:16701 CLEVELAND ST
Mailing Address - Street 2:#200
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-0901
Mailing Address - Country:US
Mailing Address - Phone:425-883-4099
Mailing Address - Fax:425-867-1546
Practice Address - Street 1:16701 CLEVELAND ST
Practice Address - Street 2:#200
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-0901
Practice Address - Country:US
Practice Address - Phone:425-883-4099
Practice Address - Fax:425-867-1546
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000044921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice