Provider Demographics
NPI:1821076936
Name:RIESNER, RONALD MILTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MILTON
Last Name:RIESNER
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 1:111 E GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:CA
Mailing Address - Zip Code:95694-1761
Mailing Address - Country:US
Mailing Address - Phone:530-795-4556
Mailing Address - Fax:530-795-4557
Practice Address - Street 1:111 E GRANT AVE
Practice Address - Street 2:
Practice Address - City:WINTERS
Practice Address - State:CA
Practice Address - Zip Code:95694-1761
Practice Address - Country:US
Practice Address - Phone:530-795-4556
Practice Address - Fax:530-795-4557
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice