Provider Demographics
NPI:1255478467
Name:RUIZ, JUAN F (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:F
Last Name:RUIZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 705
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0705
Mailing Address - Country:US
Mailing Address - Phone:787-880-1681
Mailing Address - Fax:787-816-6453
Practice Address - Street 1:540 AVE MIRAMAR
Practice Address - Street 2:SUITE #6
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4364
Practice Address - Country:US
Practice Address - Phone:787-880-1681
Practice Address - Fax:787-816-6453
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry