Provider Demographics
NPI:1831425701
Name:SVOBODA, RONALD J (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:SVOBODA
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 1:1221 CAMBIA DR
Mailing Address - Street 2:APT 1108
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-4677
Mailing Address - Country:US
Mailing Address - Phone:630-856-4687
Mailing Address - Fax:
Practice Address - Street 1:1061 S ROSELLE RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-3960
Practice Address - Country:US
Practice Address - Phone:847-301-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019014994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist