Provider Demographics
NPI:1013113414
Name:DAVIES, RONALD OWEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:OWEN
Last Name:DAVIES
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 1:28241 CROWN VALLEY PKY PMB 620
Mailing Address - Street 2:STE F 620
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677
Mailing Address - Country:US
Mailing Address - Phone:949-362-9690
Mailing Address - Fax:949-448-8858
Practice Address - Street 1:28241 CROWN VALLEY PKWY PMB 620
Practice Address - Street 2:STE. F 620
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-4441
Practice Address - Country:US
Practice Address - Phone:949-362-9690
Practice Address - Fax:949-448-8858
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247621223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist