Provider Demographics
NPI:1356423735
Name:VITULLO, RONALD ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ANTHONY
Last Name:VITULLO
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 1:3140 DAYTON XENIA RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6396
Mailing Address - Country:US
Mailing Address - Phone:937-426-2253
Mailing Address - Fax:937-797-0677
Practice Address - Street 1:3140 DAYTON XENIA RD UNIT D
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6396
Practice Address - Country:US
Practice Address - Phone:937-426-2253
Practice Address - Fax:937-797-0677
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0222251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice