Provider Demographics
NPI:1649351396
Name:QUADE, RONALD B (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:B
Last Name:QUADE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:KEAAU FAMILY HEALTH CENTER
Mailing Address - Street 2:16-192 PILIMUA STREET
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749
Mailing Address - Country:US
Mailing Address - Phone:808-930-0400
Mailing Address - Fax:808-930-0438
Practice Address - Street 1:KEAAU FAMILY HEALTH CENTER
Practice Address - Street 2:16-192 PILIMUA STREET
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-930-0400
Practice Address - Fax:808-930-0438
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HICSDT-18122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist