Provider Demographics
NPI:1568433100
Name:ARREOLA, RAMON T (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:T
Last Name:ARREOLA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020
Mailing Address - Country:US
Mailing Address - Phone:610-882-9350
Mailing Address - Fax:610-691-8278
Practice Address - Street 1:1020 W BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:610-691-6900
Practice Address - Fax:610-691-8278
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022129-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008142240002Medicaid