Provider Demographics
NPI:1093963464
Name:ROBERT A RUCHO, DDS, RALPH M. HOFFMAN, DMD, PA.
Entity Type:Organization
Organization Name:ROBERT A RUCHO, DDS, RALPH M. HOFFMAN, DMD, PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & SECRETARY (OWNER)
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-364-3770
Mailing Address - Street 1:3535 RANDOLPH RD
Mailing Address - Street 2:SUITE R-100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211
Mailing Address - Country:US
Mailing Address - Phone:704-364-3770
Mailing Address - Fax:704-364-5878
Practice Address - Street 1:3535 RANDOLPH RD
Practice Address - Street 2:SUITE R-100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-364-3770
Practice Address - Fax:704-364-5878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC43031223P0700X
NCNC68991223P0700X
NCNC83191223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty