Provider Demographics
NPI:1780628263
Name:SCHIFFERS, RONALD H (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:H
Last Name:SCHIFFERS
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 1:1708 MARVIN PKWY
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2425
Mailing Address - Country:US
Mailing Address - Phone:847-698-1259
Mailing Address - Fax:
Practice Address - Street 1:1308 W 2ND ST
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-1005
Practice Address - Country:US
Practice Address - Phone:815-626-2230
Practice Address - Fax:815-626-6339
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190191821223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1003626OtherDORAL PROVIDER NUMBER