Provider Demographics
NPI:1629289012
Name:SEMELSBERGER, RONALD EUGENE (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EUGENE
Last Name:SEMELSBERGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27552 SIERRA HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351
Mailing Address - Country:US
Mailing Address - Phone:661-252-3533
Mailing Address - Fax:661-252-2022
Practice Address - Street 1:27552 SIERRA HIGHWAY
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351
Practice Address - Country:US
Practice Address - Phone:661-252-3533
Practice Address - Fax:661-252-2022
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25029122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist