Provider Demographics
NPI:1851495170
Name:RICE, RONALD C (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:C
Last Name:RICE
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 1:515 E 5TH ST. N
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318
Mailing Address - Country:US
Mailing Address - Phone:208-679-3000
Mailing Address - Fax:208-679-7644
Practice Address - Street 1:515 E 5TH ST. N
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318
Practice Address - Country:US
Practice Address - Phone:208-679-3000
Practice Address - Fax:208-679-7644
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD33031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID979635OtherUNITED CONCORDIA
ID979635OtherGEHA
ID979635OtherCONNECTION DENTAL PLANS
ID000001009869OtherREGENCE BLUE SHIELD OF ID
ID6B158OtherBLUE CROSS OF IDAHO