Provider Demographics
NPI:1851330377
Name:HOUSE, RONALD CLEVE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CLEVE
Last Name:HOUSE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-6572
Mailing Address - Country:US
Mailing Address - Phone:304-296-4774
Mailing Address - Fax:
Practice Address - Street 1:1055 HEALTH SCIENCES NORTH
Practice Address - Street 2:ROOM 1056
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-9460
Practice Address - Country:US
Practice Address - Phone:304-293-1142
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV33401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice