Provider Demographics
NPI:1639244460
Name:UILKIE, RONALD PHILIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:PHILIP
Last Name:UILKIE
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 1:705 MAIN ST SW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-8308
Mailing Address - Country:US
Mailing Address - Phone:505-865-3395
Mailing Address - Fax:505-865-1414
Practice Address - Street 1:705 MAIN ST SW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-8308
Practice Address - Country:US
Practice Address - Phone:505-865-3395
Practice Address - Fax:505-865-1414
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD15911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice