Provider Demographics
NPI:1932363165
Name:JARVIS, RONALD CLIFTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CLIFTON
Last Name:JARVIS
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 1:85 VILLAGE LOOP RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2859
Mailing Address - Country:US
Mailing Address - Phone:406-257-5696
Mailing Address - Fax:406-257-5693
Practice Address - Street 1:85 VILLAGE LOOP RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2859
Practice Address - Country:US
Practice Address - Phone:406-257-5696
Practice Address - Fax:406-257-5693
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice