Provider Demographics
NPI:1720236342
Name:RONALD L. CIOMBOR D.D.S.
Entity Type:Organization
Organization Name:RONALD L. CIOMBOR D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CIOMBOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:401-726-1772
Mailing Address - Street 1:536 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-1947
Mailing Address - Country:US
Mailing Address - Phone:401-726-1772
Mailing Address - Fax:401-305-3627
Practice Address - Street 1:536 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-1947
Practice Address - Country:US
Practice Address - Phone:401-726-1772
Practice Address - Fax:401-305-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI16601223G0001X
RI29351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty