Doctor Name: | DR. RONALD LEWIS PROCTOR |
NPI Number: | 1881691459 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | 10344 |
Business Practice Address: | 3740 N Josey Ln Ste 121 Carrollton, TX - 750072471 |
Business Phone Number: | 9724922866 |
Business Fax Number: | 9723940583 |
Mailing Address: | 3740 N Josey Ln, Ste 121 CARROLLTON |
State: | TX |
Postal Code: | 750072471 |
Phone Number: | 9724922866 |
Fax Number: | 9723940583 |
NPI Enumeration Date: | 06/28/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 10344 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |