Provider Demographics
NPI:1710019294
Name:SCHNELL, RONNI A (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONNI
Middle Name:A
Last Name:SCHNELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 HIGH ST
Mailing Address - Street 2:SUITE DH-12
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3850
Mailing Address - Country:US
Mailing Address - Phone:781-396-4131
Mailing Address - Fax:781-396-2064
Practice Address - Street 1:92 HIGH ST
Practice Address - Street 2:DH-12
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3850
Practice Address - Country:US
Practice Address - Phone:781-396-4131
Practice Address - Fax:781-396-2064
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA147941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice