Provider Demographics
NPI:1932295615
Name:WOLLARD, RONALD REED (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:REED
Last Name:WOLLARD
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 1:444 W 47TH STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1952
Mailing Address - Country:US
Mailing Address - Phone:816-561-9666
Mailing Address - Fax:816-561-8304
Practice Address - Street 1:444 W 47TH STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1952
Practice Address - Country:US
Practice Address - Phone:816-561-9666
Practice Address - Fax:816-561-8304
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics