Provider Demographics
NPI:1053431247
Name:BARNGROVER, RONALD DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DAVID
Last Name:BARNGROVER
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 1:4085 S 2200 W
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-6574
Mailing Address - Country:US
Mailing Address - Phone:801-886-1116
Mailing Address - Fax:801-886-1151
Practice Address - Street 1:4085 S 2200 W
Practice Address - Street 2:SUITE B
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84119-6574
Practice Address - Country:US
Practice Address - Phone:801-886-1116
Practice Address - Fax:801-886-1151
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT143375-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice