Provider Demographics
NPI:1528335338
Name:LAUB, RONALD DANE (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:DANE
Last Name:LAUB
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 1:722 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2235
Mailing Address - Country:US
Mailing Address - Phone:540-463-4332
Mailing Address - Fax:540-463-1940
Practice Address - Street 1:722 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2235
Practice Address - Country:US
Practice Address - Phone:540-463-4332
Practice Address - Fax:540-463-1940
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA410334122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist