Provider Demographics
NPI:1649386012
Name:HULL, RONALD WARREN (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:WARREN
Last Name:HULL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:W
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:700 W WALWORTH ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-1517
Mailing Address - Country:US
Mailing Address - Phone:262-723-2911
Mailing Address - Fax:262-723-2933
Practice Address - Street 1:700 W WALWORTH ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-1517
Practice Address - Country:US
Practice Address - Phone:262-723-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2828122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist