Provider Demographics
NPI:1881718468
Name:RONALD G ROBERTSON JR DDS INC
Entity type:Organization
Organization Name:RONALD G ROBERTSON JR DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-569-1456
Mailing Address - Street 1:7 W ISLAY ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2412
Mailing Address - Country:US
Mailing Address - Phone:805-569-1456
Mailing Address - Fax:805-569-3327
Practice Address - Street 1:7 W ISLAY ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2412
Practice Address - Country:US
Practice Address - Phone:805-569-1456
Practice Address - Fax:805-569-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADK0347621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty