Provider Demographics
NPI:1699929620
Name:VINSON, RONNIE MCVAE SR (DDS)
Entity type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:MCVAE
Last Name:VINSON
Suffix:SR
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 1:2136 MIRABEAU AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-3920
Mailing Address - Country:US
Mailing Address - Phone:504-282-3354
Mailing Address - Fax:504-283-7200
Practice Address - Street 1:2136 MIRABEAU AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-3920
Practice Address - Country:US
Practice Address - Phone:504-282-3354
Practice Address - Fax:504-283-7200
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2670122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist