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Individual
DR. RONALD DEAN JESSUP
Active
Individual
DR. RONALD DEAN JESSUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008645
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00701762
UNITED CONCORDIA
VA
05
—
007800568
—
VA
01
—
041008645A
DELTA DENTAL
VA
Enumeration date
10/16/2007
Last updated
10/28/2010
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