Provider Demographics
NPI:1871752931
Name:AANERUD, RONALD A (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:AANERUD
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 1:16766 BERNARDO CTR DR
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2501
Mailing Address - Country:US
Mailing Address - Phone:858-485-6781
Mailing Address - Fax:
Practice Address - Street 1:16766 BERNARDO CTR DR
Practice Address - Street 2:SUITE 100A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2501
Practice Address - Country:US
Practice Address - Phone:858-485-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice