Individual
DR. RONALD MICHAEL SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1702 OAK PARK BLVD, LAKE CHARLES, LA 70601-8912
(337) 310-1800
(337) 310-1143
Mailing address
630 W PRIEN LAKE RD, SUITE B223, LAKE CHARLES, LA 70601-0700
(337) 310-1800
(337) 310-1143
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2380
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1823805
—
LA
Enumeration date
03/29/2007
Last updated
07/09/2007
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