Individual
RONALD W RISTOW
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737
Mailing address
PO BOX 1440, WAUTOMA, WI 54982-1440
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5373-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33776600
—
WI
Enumeration date
06/08/2005
Last updated
07/08/2007
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