Provider Demographics
NPI:1184781601
Name:JOW, RONALD (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:JOW
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 1:1240 WEST ROBINHOOD DR
Mailing Address - Street 2:STE #D
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5507
Mailing Address - Country:US
Mailing Address - Phone:209-472-7088
Mailing Address - Fax:
Practice Address - Street 1:1240 WEST ROBINHOOD
Practice Address - Street 2:STE #D
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5507
Practice Address - Country:US
Practice Address - Phone:209-472-7088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32861122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist