Provider Demographics
NPI:1740243781
Name:SILLS, RONALD F (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:F
Last Name:SILLS
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 1:4111 BARBARA LOOP SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1068
Mailing Address - Country:US
Mailing Address - Phone:505-892-6329
Mailing Address - Fax:
Practice Address - Street 1:4111 BARBARA LOOP SE
Practice Address - Street 2:SUITE B
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1068
Practice Address - Country:US
Practice Address - Phone:505-892-6329
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM13631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice