Provider Demographics
NPI:1699782441
Name:MUELLER, RONALD KEITH (DDS)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:KEITH
Last Name:MUELLER
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:PO BOX 180
Mailing Address - Street 2:US 2 41
Mailing Address - City:POWERS
Mailing Address - State:MI
Mailing Address - Zip Code:49874
Mailing Address - Country:US
Mailing Address - Phone:906-497-5844
Mailing Address - Fax:906-497-6453
Practice Address - Street 1:W3811 US 2 41
Practice Address - Street 2:
Practice Address - City:POWERS
Practice Address - State:MI
Practice Address - Zip Code:49874
Practice Address - Country:US
Practice Address - Phone:906-497-5844
Practice Address - Fax:906-497-5844
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901013184122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist