Provider Demographics
NPI:1033320775
Name:RUZZO, JOSEPH A (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:RUZZO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 JONES BRANCH DR
Mailing Address - Street 2:220
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3338
Mailing Address - Country:US
Mailing Address - Phone:703-448-3312
Mailing Address - Fax:703-448-3938
Practice Address - Street 1:7901 JONES BRANCH DR., SUITE 220
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3338
Practice Address - Country:US
Practice Address - Phone:703-448-3312
Practice Address - Fax:703-448-3938
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010074251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice