Provider Demographics
NPI:1538121777
Name:BROOKS, RONALD C (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:C
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JASON
Other - Middle Name:A
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:347 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1338
Mailing Address - Country:US
Mailing Address - Phone:207-839-3006
Mailing Address - Fax:207-839-4593
Practice Address - Street 1:347 MAIN ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1338
Practice Address - Country:US
Practice Address - Phone:207-839-3006
Practice Address - Fax:207-839-4593
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2221122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist