Provider Demographics
NPI:1922274018
Name:HAUPTMAN, RONALD S (DDS)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:S
Last Name:HAUPTMAN
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 1:311 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3300
Mailing Address - Country:US
Mailing Address - Phone:703-241-0666
Mailing Address - Fax:703-241-8414
Practice Address - Street 1:311 PARK AVE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3300
Practice Address - Country:US
Practice Address - Phone:703-241-0666
Practice Address - Fax:703-241-8414
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010058031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice