Provider Demographics
NPI:1437209947
Name:WARD, RUFUS CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUFUS
Middle Name:CHARLES
Last Name:WARD
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 1:575 E 4500 S STE B220
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-4515
Mailing Address - Country:US
Mailing Address - Phone:801-261-3622
Mailing Address - Fax:801-261-3623
Practice Address - Street 1:575 E 4500 S STE B220
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-4515
Practice Address - Country:US
Practice Address - Phone:801-261-3622
Practice Address - Fax:801-261-3623
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT136783-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice