Individual
DR. RONALD L TANKERSLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
716 DENBIGH BLVD, NEWPORT NEWS, VA 23608-4414
(757) 874-6501
Mailing address
1404 RIVERS EDGE RD., NEWPORT NEWS, VA 23606
(757) 874-6501
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3791
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
243303
ANTHEM
VI
01
—
583329
UNITED CONCORDIA
VA
Enumeration date
11/29/2005
Last updated
07/08/2007
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