Provider Demographics
NPI:1316126352
Name:SOWAL, RONALD THOMAS (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:THOMAS
Last Name:SOWAL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-8555
Mailing Address - Country:US
Mailing Address - Phone:717-652-4551
Mailing Address - Fax:717-652-7305
Practice Address - Street 1:4655 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-8555
Practice Address - Country:US
Practice Address - Phone:717-652-4551
Practice Address - Fax:717-652-7305
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029621-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice