Provider Demographics
NPI:1487861845
Name:BROWNFIELD, RONALD DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DEAN
Last Name:BROWNFIELD
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 1:331 N EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62522-2227
Mailing Address - Country:US
Mailing Address - Phone:217-423-8542
Mailing Address - Fax:217-423-6639
Practice Address - Street 1:331 N EDWARD ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62522-2227
Practice Address - Country:US
Practice Address - Phone:217-423-8542
Practice Address - Fax:217-423-6639
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist