Provider Demographics
NPI:1790873529
Name:EGGE, RONALD DENNIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DENNIS
Last Name:EGGE
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 1:1565 A EAST TRINITY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106
Mailing Address - Country:US
Mailing Address - Phone:334-277-0718
Mailing Address - Fax:334-277-0285
Practice Address - Street 1:1565 A EAST TRINITY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106
Practice Address - Country:US
Practice Address - Phone:334-277-0718
Practice Address - Fax:334-277-0285
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice