Provider Demographics
NPI:1871022053
Name:AASAR, RONIA
Entity Type:Individual
Prefix:
First Name:RONIA
Middle Name:
Last Name:AASAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 BROADWAY ST STE B
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-2959
Mailing Address - Country:US
Mailing Address - Phone:765-642-3124
Mailing Address - Fax:765-642-1095
Practice Address - Street 1:777 BROADWAY ST STE B
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-2959
Practice Address - Country:US
Practice Address - Phone:765-642-3124
Practice Address - Fax:765-642-1095
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012750A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist