Provider Demographics
NPI:1760539373
Name:RANSON, CHARLES SCOTT (DMD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:SCOTT
Last Name:RANSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:897 PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2305
Mailing Address - Country:US
Mailing Address - Phone:609-882-7803
Mailing Address - Fax:609-882-8717
Practice Address - Street 1:897 PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-2305
Practice Address - Country:US
Practice Address - Phone:609-882-7803
Practice Address - Fax:609-882-8717
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 15373001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice