Provider Demographics
NPI:1497170948
Name:CAMBRIDGE DENTISTRY
Entity Type:Organization
Organization Name:CAMBRIDGE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUGGIRELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-677-7944
Mailing Address - Street 1:51218 ROMEO PLANK RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-4129
Mailing Address - Country:US
Mailing Address - Phone:586-677-7944
Mailing Address - Fax:586-677-7956
Practice Address - Street 1:51218 ROMEO PLANK RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-4129
Practice Address - Country:US
Practice Address - Phone:586-677-7944
Practice Address - Fax:586-677-7956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI170051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty