Provider Demographics
NPI:1417906736
Name:RUIZ, FRANCISCO (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
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 1:1061 HARMON AVE BLDG 357
Mailing Address - Street 2:
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5641
Mailing Address - Country:US
Mailing Address - Phone:912-435-7006
Mailing Address - Fax:
Practice Address - Street 1:230 DUNCAN DRIVE
Practice Address - Street 2:BLDG. 1440 SUITE C121
Practice Address - City:HUNTER ARMY AIRFIELD
Practice Address - State:GA
Practice Address - Zip Code:31409
Practice Address - Country:US
Practice Address - Phone:912-315-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028278L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice