Provider Demographics
NPI:1700085933
Name:PREHN, RONALD SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:SCOTT
Last Name:PREHN
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 1:304 MOUNTAIN DEW
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BAY
Mailing Address - State:TX
Mailing Address - Zip Code:78657-2175
Mailing Address - Country:US
Mailing Address - Phone:832-326-4074
Mailing Address - Fax:715-802-8568
Practice Address - Street 1:10418 LAKE CREEK PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1226
Practice Address - Country:US
Practice Address - Phone:512-258-8001
Practice Address - Fax:512-258-4106
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19309122300000X, 1223G0001X
WI3010-151223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist