Provider Demographics
NPI:1588398101
Name:RONNETTA J. P. SARTOR, DMD, LLC
Entity type:Organization
Organization Name:RONNETTA J. P. SARTOR, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-971-0407
Mailing Address - Street 1:521 GROVE BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-9041
Mailing Address - Country:US
Mailing Address - Phone:803-971-0407
Mailing Address - Fax:
Practice Address - Street 1:101 STANDARD WAREHOUSE RD
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-9670
Practice Address - Country:US
Practice Address - Phone:803-438-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty