Provider Demographics
NPI:1740353036
Name:RONALD H. HONEYCUTT DDS,PA
Entity type:Organization
Organization Name:RONALD H. HONEYCUTT DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:HONEYCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-592-1766
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28329-0003
Mailing Address - Country:US
Mailing Address - Phone:910-592-1766
Mailing Address - Fax:910-592-8267
Practice Address - Street 1:705 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2605
Practice Address - Country:US
Practice Address - Phone:910-592-1766
Practice Address - Fax:910-592-8267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8994063Medicaid