Provider Demographics
NPI:1740263169
Name:RONCONE, CHRISTOPHER (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:RONCONE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32140 US HIGHWAY 79
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-9509
Mailing Address - Country:US
Mailing Address - Phone:951-302-9911
Mailing Address - Fax:
Practice Address - Street 1:32140 US HIGHWAY 79
Practice Address - Street 2:SUITE 201
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-9509
Practice Address - Country:US
Practice Address - Phone:951-302-9911
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics