Provider Demographics
NPI:1629000161
Name:OSTOMEL, RON (DMD)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:OSTOMEL
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 1:3715 RAILROAD AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5236
Mailing Address - Country:US
Mailing Address - Phone:925-432-3347
Mailing Address - Fax:925-432-3269
Practice Address - Street 1:3715 RAILROAD AVE
Practice Address - Street 2:SUITE E
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5236
Practice Address - Country:US
Practice Address - Phone:925-432-3347
Practice Address - Fax:925-432-3269
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA217371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice