Provider Demographics
NPI:1659466522
Name:GOERS, RONALD W (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:W
Last Name:GOERS
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 1:115 55TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1593
Mailing Address - Country:US
Mailing Address - Phone:630-789-0900
Mailing Address - Fax:630-789-3861
Practice Address - Street 1:115 55TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-1593
Practice Address - Country:US
Practice Address - Phone:630-789-0900
Practice Address - Fax:630-789-3861
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist