Provider Demographics
NPI:1871670976
Name:RONCONE, JOHN DOMINIC (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DOMINIC
Last Name:RONCONE
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 1:714 WINTON RD NORTH
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-7892
Mailing Address - Country:US
Mailing Address - Phone:585-482-5050
Mailing Address - Fax:585-482-7196
Practice Address - Street 1:714 WINTON RD NORTH
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-7892
Practice Address - Country:US
Practice Address - Phone:585-482-5050
Practice Address - Fax:585-482-7196
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist