Provider Demographics
NPI:1205516259
Name:RANSHAW, GEORGE DALTON (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DALTON
Last Name:RANSHAW
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 1:7045 HELM ST APT 3203
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-9029
Mailing Address - Country:US
Mailing Address - Phone:812-584-8807
Mailing Address - Fax:
Practice Address - Street 1:2001 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-2048
Practice Address - Country:US
Practice Address - Phone:812-584-8077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014174A1223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice