Provider Demographics
NPI:1518184563
Name:RONALD S. CAVOLA, DDS, PC
Entity Type:Organization
Organization Name:RONALD S. CAVOLA, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAVOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-929-8555
Mailing Address - Street 1:2005 HONEY CREEK PKWY SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2975
Mailing Address - Country:US
Mailing Address - Phone:770-929-8555
Mailing Address - Fax:770-929-8582
Practice Address - Street 1:2005 HONEY CREEK PKWY SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2975
Practice Address - Country:US
Practice Address - Phone:770-929-8555
Practice Address - Fax:770-929-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10477122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty