Provider Demographics
NPI:1952411878
Name:ISBELL, RONALD L (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:ISBELL
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 1:18 WEST BURLINGTON
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1672
Mailing Address - Country:US
Mailing Address - Phone:630-964-9450
Mailing Address - Fax:630-964-8910
Practice Address - Street 1:18 WEST BURLINGTON
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1672
Practice Address - Country:US
Practice Address - Phone:630-964-9450
Practice Address - Fax:630-964-8910
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19AI3520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist