Provider Demographics
NPI:1770690570
Name:GEORGE, RONALD A (DMD, PA)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:GEORGE
Suffix:
Gender:M
Credentials:DMD, PA
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Other - Credentials:
Mailing Address - Street 1:4100 S HOSPITAL DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2813
Mailing Address - Country:US
Mailing Address - Phone:954-792-6002
Mailing Address - Fax:954-792-6121
Practice Address - Street 1:4100 S HOSPITAL DR
Practice Address - Street 2:SUITE 107
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2813
Practice Address - Country:US
Practice Address - Phone:954-792-6002
Practice Address - Fax:954-792-6121
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL00139931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL071673100Medicaid