Provider Demographics
NPI:1447300108
Name:NOVOSAD, RONALD ROLAND (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ROLAND
Last Name:NOVOSAD
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 1:2539 S. GESSNER
Mailing Address - Street 2:SUITE 22
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063
Mailing Address - Country:US
Mailing Address - Phone:713-783-1990
Mailing Address - Fax:713-974-1648
Practice Address - Street 1:2539 S. GESSNER RD.
Practice Address - Street 2:SUITE 22
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2028
Practice Address - Country:US
Practice Address - Phone:713-783-1990
Practice Address - Fax:713-974-1648
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice