Provider Demographics
NPI:1316167315
Name:ROMPF, ERNEST J (D,DS)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:J
Last Name:ROMPF
Suffix:
Gender:M
Credentials:D,DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16170 WACOUSTA RD
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-9206
Mailing Address - Country:US
Mailing Address - Phone:517-622-0638
Mailing Address - Fax:
Practice Address - Street 1:6452 MILLENNIUM
Practice Address - Street 2:STE 110
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-7881
Practice Address - Country:US
Practice Address - Phone:517-327-7470
Practice Address - Fax:517-327-7479
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI129171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice