Provider Demographics
NPI:1528249182
Name:CARIC, RON (DDS)
Entity type:Individual
Prefix:DR
First Name:RON
Middle Name:
Last Name:CARIC
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 1:889 NEWARK POND RD
Mailing Address - Street 2:
Mailing Address - City:WEST BURKE
Mailing Address - State:VT
Mailing Address - Zip Code:05871-9612
Mailing Address - Country:US
Mailing Address - Phone:802-626-6111
Mailing Address - Fax:
Practice Address - Street 1:510 BROAD ST
Practice Address - Street 2:
Practice Address - City:LYNDONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05851-8629
Practice Address - Country:US
Practice Address - Phone:802-626-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist