Provider Demographics
NPI:1881216844
Name:RONALD D SCHOWENGERDT DDS
Entity Type:Organization
Organization Name:RONALD D SCHOWENGERDT DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHOWENGERDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-667-7134
Mailing Address - Street 1:1701 W AUSTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3720
Mailing Address - Country:US
Mailing Address - Phone:417-667-7134
Mailing Address - Fax:417-667-4127
Practice Address - Street 1:1701 W AUSTIN BLVD
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-3720
Practice Address - Country:US
Practice Address - Phone:417-667-7134
Practice Address - Fax:417-667-4127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty