# RONALD W HOUSEHOLDER DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255834610
- **Authorized official:** DR. RONALD WAYNE HOUSEHOLDER DDS (OWNER/DENTIST)
- **Authorized official phone:** (276) 988-7522

## Contact information

- **Practice address:** 316 BEN BOLT AVE, TAZEWELL, VA 24651-5386
- **Practice address phone:** (276) 988-7522
- **Practice address fax:** (276) 988-5866
- **Mailing address:** PO BOX 542, NORTH TAZEWELL, VA 24630-0542
- **Mailing address phone:** (276) 988-7522
- **Mailing address fax:** (276) 988-5866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 0401005792 | VA | Yes |

## Other

- **Enumeration date:** 03/13/2018
- **Last updated:** 03/13/2018