Provider Demographics
NPI:1639358542
Name:STRISOFSKY, RONALD R JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:R
Last Name:STRISOFSKY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3835 GREEN POND RD
Mailing Address - Street 2:NORTHAMPTON COMMUNITY COLLEGE
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020
Mailing Address - Country:US
Mailing Address - Phone:610-861-5441
Mailing Address - Fax:610-861-4139
Practice Address - Street 1:3835 GREEN POND RD
Practice Address - Street 2:NORTHAMPTON COMMUNITY COLLEGE
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020
Practice Address - Country:US
Practice Address - Phone:610-861-5441
Practice Address - Fax:610-861-4139
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027404L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
77595OtherMED PLUS
0006453OtherAMERIHEALTH MERCY