Provider Demographics
NPI:1487657193
Name:HEIBER, RONALD GEORGE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:GEORGE
Last Name:HEIBER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 E FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2746
Mailing Address - Country:US
Mailing Address - Phone:740-654-6006
Mailing Address - Fax:740-654-6439
Practice Address - Street 1:1011 E FAIR AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2746
Practice Address - Country:US
Practice Address - Phone:740-654-6006
Practice Address - Fax:740-654-6439
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH138871223X0400X
CO3691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Not Answered1223G0001XDental ProvidersDentistGeneral Practice