Provider Demographics
NPI:1134303225
Name:LIMOSNERO, ROLAND C (DDS)
Entity type:Individual
Prefix:
First Name:ROLAND
Middle Name:C
Last Name:LIMOSNERO
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 1:5110 HERITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5910
Mailing Address - Country:US
Mailing Address - Phone:817-318-5600
Mailing Address - Fax:817-354-1210
Practice Address - Street 1:5110 HERITAGE AVE
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5910
Practice Address - Country:US
Practice Address - Phone:817-318-5600
Practice Address - Fax:817-354-1210
Is Sole Proprietor?:No
Enumeration Date:2007-12-25
Last Update Date:2007-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX183161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice