Provider Demographics
NPI:1053374215
Name:RONALD MARTELLA DDS PLC
Entity type:Organization
Organization Name:RONALD MARTELLA DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-545-6400
Mailing Address - Street 1:2241 HILTON RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1459
Mailing Address - Country:US
Mailing Address - Phone:248-545-6400
Mailing Address - Fax:248-545-8530
Practice Address - Street 1:2241 HILTON RD
Practice Address - Street 2:SUITE #1
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1459
Practice Address - Country:US
Practice Address - Phone:248-545-6400
Practice Address - Fax:248-545-8530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI122001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty