Provider Demographics
NPI:1780659243
Name:PROTZMAN, RONALD G (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:PROTZMAN
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 1:1409 STANTON ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-6170
Mailing Address - Country:US
Mailing Address - Phone:620-342-3600
Mailing Address - Fax:866-882-2978
Practice Address - Street 1:1409 STANTON ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6170
Practice Address - Country:US
Practice Address - Phone:620-342-3600
Practice Address - Fax:866-882-2978
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS 4712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist