Provider Demographics
NPI:1790899730
Name:CONDER, RONALD FREDERICK SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:FREDERICK
Last Name:CONDER
Suffix:SR
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 1:163 CADILLAC COURT
Mailing Address - Street 2:SUITE #4
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-1737
Mailing Address - Country:US
Mailing Address - Phone:815-547-9509
Mailing Address - Fax:815-544-1165
Practice Address - Street 1:163 CADILLAC COURT
Practice Address - Street 2:SUITE #4
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-1737
Practice Address - Country:US
Practice Address - Phone:815-547-9509
Practice Address - Fax:815-544-1165
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-022739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist