Provider Demographics
NPI:1568485282
Name:ACHONG, RONALD MICHAEL (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MICHAEL
Last Name:ACHONG
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4420
Mailing Address - Country:US
Mailing Address - Phone:407-932-0883
Mailing Address - Fax:407-932-4251
Practice Address - Street 1:200 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4420
Practice Address - Country:US
Practice Address - Phone:407-932-0883
Practice Address - Fax:407-932-4251
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN169131223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery