Provider Demographics
NPI:1407072994
Name:RUFFING, JACK FORREST JR (DDS)
Entity Type:Individual
Prefix:
First Name:JACK
Middle Name:FORREST
Last Name:RUFFING
Suffix:JR
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 1:9230 NORTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-2921
Mailing Address - Country:US
Mailing Address - Phone:713-462-4144
Mailing Address - Fax:
Practice Address - Street 1:9320 WESTVIEW
Practice Address - Street 2:SUITE 7
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6414
Practice Address - Country:US
Practice Address - Phone:713-932-8600
Practice Address - Fax:713-932-8600
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11125122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist