Provider Demographics
NPI:1902352487
Name:RONALD J. WILL D.D.S., PLLC
Entity Type:Organization
Organization Name:RONALD J. WILL D.D.S., PLLC
Other - Org Name:MT, SPOKANE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-465-2252
Mailing Address - Street 1:14017 N NEWPORT HWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021
Mailing Address - Country:US
Mailing Address - Phone:509-465-2252
Mailing Address - Fax:509-465-1669
Practice Address - Street 1:14017 N NEWPORT HWY
Practice Address - Street 2:SUITE E
Practice Address - City:MEAD
Practice Address - State:WA
Practice Address - Zip Code:99021
Practice Address - Country:US
Practice Address - Phone:509-465-2252
Practice Address - Fax:509-465-1669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA92151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty