Provider Demographics
NPI:1689693061
Name:RAMOS, SERVANDO JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:SERVANDO
Middle Name:
Last Name:RAMOS
Suffix:JR
Gender:M
Credentials:DDS
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Other - Last Name:
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Mailing Address - Street 1:BLDG 38801 ACADEMIC DR SUITE B & C
Mailing Address - Street 2:USA DENTAC
Mailing Address - City:FT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5660
Mailing Address - Country:US
Mailing Address - Phone:706-787-6927
Mailing Address - Fax:706-787-2082
Practice Address - Street 1:BLDG 38801 ACADEMIC DR SUITE B & C
Practice Address - Street 2:USA DENTAC
Practice Address - City:FT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5660
Practice Address - Country:US
Practice Address - Phone:706-787-6927
Practice Address - Fax:706-787-2082
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX148041223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics