Provider Demographics
NPI:1932450103
Name:RANNEY, PAUL D JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:RANNEY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BICKNELL
Mailing Address - State:IN
Mailing Address - Zip Code:47512-9628
Mailing Address - Country:US
Mailing Address - Phone:812-735-2020
Mailing Address - Fax:812-735-2121
Practice Address - Street 1:511 W 11TH ST
Practice Address - Street 2:
Practice Address - City:BICKNELL
Practice Address - State:IN
Practice Address - Zip Code:47512-9628
Practice Address - Country:US
Practice Address - Phone:812-735-2020
Practice Address - Fax:812-735-2121
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011868A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist